Devices, methods and systems for reducing sample volume

ABSTRACT

Devices, methods and systems are provided for reducing the sample volume required for analysis. Inserts placed within a sample container, and substitute sample containers having smaller volume sample chambers are provided. Methods are provided for detection and quantification of target substances in reduced volume samples. Methods include placing a small-volume of sample in a small-volume insert. Methods include diluting a small-volume sample, and placing the diluted sample in a small-volume insert. Methods include reducing the volume of sample, and: increasing illumination; increasing dye concentration or amount; increasing the amount of an enzyme substrate; increasing the amounts, concentration, or labeling of antibodies for detection; increasing optical detector sensitivity; increasing the path length of light passing through the sample; decreasing the separation between sample and detector; altering the wavelength, or polarization, or number of wavelengths, passing through the sample; increasing electronic amplification of electrical signals; altering assay temperature; and other alterations.

BACKGROUND

Detection of analytes in a sample and determination of the chemicalcomposition of a sample are useful in many clinical and scientificapplications. Thus, methods, devices, and systems for analyzing samplesand for detecting target substances within the samples are useful inmany contexts. A method of testing for, or for detecting, a targetsubstance in a sample may be termed an “assay.” Some assays may beperformed by devices or systems with little or no human intervention;such assays may be termed automated assays, and are performed byautomatic devices or automatic systems.

Clinical assays are often developed to identify target materials insamples taken from patients. For example, targets may include proteins,nucleic acids, lipids, organic molecules, inorganic molecules and ions.Such target materials may include drugs, drug metabolites, vitamins,hormones, growth factors, carrier proteins, cells, infectious agents,and other target materials that may be indicative of medical conditionsor disorders. Other clinical assays may be directed to testing forlevels of drugs, drug metabolites, hormones, vitamins, or othersubstances which may be of therapeutic or clinical interest. In someinstances, a sample may include multiple analytes, and multiple assaysmay be required to detect or quantify all of the analytes of interest ina sample.

Clinical assays require samples to be obtained from a subject, such as apatient suffering from, or suspected of suffering from, a diseasecharacterized by markers identifiable by the assay. However, providingsamples is often uncomfortable, or difficult, or inconvenient for asubject; the discomfort, difficulty, and inconvenience is typicallygreater the larger the volume of sample that is required.

Accordingly, methods and devices for reducing the volume of samplerequired to be obtained from a subject are desired, and assays,guidelines and methods for altering existing machines and assays thatmay be performed on smaller volume samples than presently practiced arealso desired.

INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in thisspecification are herein incorporated by reference to the same extent asif each individual publication, patent, or patent application wasspecifically and individually indicated to be incorporated by reference.

SUMMARY

Analysis of fluid samples typically requires that a volume of sample beheld in a container during analysis. Typically a fluid sample isdeposited in a tube or other vessel when first obtained from thesubject, and then transferred to a container in, or for use in, a sampleanalysis device. A sample analysis device will have a minimum volumebelow which a fluid sample is too small for analysis. Applicantdiscloses herein methods, devices, and systems for reducing the volumeof sample required for use in sample analysis devices, including inautomatic sample analysis devices. For example, Applicant disclosesherein methods, devices, and systems including inserts configured tohold small volumes, including small volumes smaller than the minimumvolume otherwise required for analysis in sample analysis devices,including in automatic sample analysis devices. For example, Applicantdiscloses herein methods, devices, and systems including at least onestep of diluting a small-volume sample, effective that the volume ofsample used in the assay may be smaller than the minimum volumeotherwise required for analysis in sample analysis devices, including inautomatic sample analysis devices. For example, Applicant disclosesherein methods, devices, and systems including inserts configured tohold small volumes, and including at least one step of diluting asmall-volume sample, effective that the volume of sample used in theassay may be smaller than the minimum volume otherwise required foranalysis in sample analysis devices, including in automatic sampleanalysis devices. In embodiments, Applicant discloses herein methods,devices, and systems in which the operation, or structure, or both, ofsample analysis devices, including automatic sample analysis devices,are altered effective that small-volume samples may be analyzed, andsmall signals obtained from such small-volume samples detected andquantified.

In embodiments, Applicant provides methods and devices for modifyingassays, and for modifying assay devices, to reduce the volume of samplerequired for the performance of assays for the detection of analytes.Devices and systems modified according to the methods disclosed herein,and using the devices disclosed herein, are able to perform analyticalassays while requiring less sample, providing greater comfort tosubjects since smaller samples are less painful to obtain; providingmore cost-effective assays and analyses, since smaller sample volumestypically require less reagent volume, and so are less costly to assay;providing less waste pursuant to the assays; and providing otheradvantages as compared to original assays and methods which requiregreater sample volumes. Samples, such as blood sample, urine samples,saliva samples, throat-swab samples, nasal-swab samples, or othersamples, may be obtained by any means. For example, blood samples may beobtained by venipuncture, finger-stick, or any other means known in theart.

Applicant provides methods for modifying a clinical analysis devicecomprising reducing the sample volume by placing an insert in a samplecontainer. Applicant provides methods for modifying a sample containerused in a clinical analysis device comprising reducing the sample volumeby placing an insert in the sample container. Applicant provides methodsfor modifying sample analysis in a clinical analysis device comprisingreducing the sample volume analyzed by the clinical analysis device byplacing an insert in the sample container. Applicant provides methodsfor modifying sample analysis in a clinical analysis device comprisingreducing the sample volume analyzed by the clinical analysis device byproviding a substitute or replacement sample container having a smallervolume than the original sample container.

Methods for reducing the volume of sample used during, or required for,sample analysis include providing an insert which fits in a samplecontainer effective to reduce the volume of sample held by the combinedsample container and insert; or providing a substitute or replacementsample container which has a smaller volume than the original samplecontainer. The sample may be contained within a sample container duringat least a portion of the performance of said original assay, saidsample container comprising an internal cavity for holding said sample,said internal cavity having a volume, and wherein any of the foregoingmethods comprise reducing said volume of said internal cavity. Inembodiments, reducing the volume of said internal cavity comprisesproviding an alternative sample container. In embodiments, reducing thevolume of said internal cavity comprises placing an insert into saidinternal cavity. In embodiments, an insert may comprise an insert cavityconfigured to hold said sample, wherein said insert cavity comprises avolume less than said internal cavity volume. Thus, in embodiments, aninsert is effective to insure that the residual amount of sampleremaining in a sample container (after draining the container) comprisesonly a small volume of sample. In embodiments, an insert may beconfigured effective to reduce the amount of residual sample volumeremaining in the insert in a sample container after draining the insertin the sample container, as compared to the amount of residual samplevolume that would remain after draining sample from the sample containerin the absence of the insert. In embodiments, an insert may beconfigured effective that optical signals indicative of the presence of,or quantification of, a target substance in a sample contained withinsaid insert may be detected by said optical detector.

Applicants further provide devices for reducing the volume of sampleheld within a sample container, wherein said sample container isconfigured to hold a first volume of sample effective to allow detectionof a target substance in said sample by a detector disposed externallyto said sample container, wherein said device comprises an insertconfigured to i) fit within said sample container, ii) hold a secondvolume of sample, wherein said second volume of sample is less than saidfirst volume of sample, and iii) allow the detection of a signalindicative of the presence of, or quantification of, a target substancein a sample contained within said insert, wherein said detectioncomprises detection by a detector disposed externally to said samplecontainer. In embodiments, the insert is configured to allow the passageof light effective that optical signals indicative of the presence of,or quantification of, a target substance in a sample contained withinsaid insert may be detected by an optical detector disposed externallyto the sample container.

Applicants disclose herein methods of sample analysis comprisingreducing the volume of sample used during analysis, by reducing thevolume of a cavity in a container used to hold the sample during theperformance of the analysis, or during the performance of a portion ofthe analysis. Applicants disclose herein methods of sample analysiscomprising reducing the dead volume of a container used to hold thesample during the performance of the analysis, or during the performanceof a portion of the analysis.

Applicants disclose a method of sample analysis with a sample analysisdevice, wherein the sample is contained within a sample containercomprising an internal cavity for holding said sample, said internalcavity having a volume of less than about 500 μL, or less than about 400μL, or less than about 300 μL, or less than about 250 μL, or less thanabout 200 μL, or less than about 150 μL, or less than about 100 μL, orless than about 50 μL, or less than about 25 μL, or less than about 15μL, or less than about 10 μL, or less than about 5 μL, or less thanabout 4 μL, or less than about 3 μL, or less than about 2 μL, or lessthan about 1 μL, or less, the method comprising: placing a sample withinsaid internal cavity of said sample container, and performing the sampleanalysis.

Applicants disclose a method of sample analysis with a sample analysisdevice, wherein the sample is contained within a sample containercomprising an internal cavity for holding said sample, and wherein theinternal cavity has a dead volume of less than about 200 μL, less thanabout 100 μL, or less than about 50 μL, or less than about 30 μL, orless than about 20 μL, or less than about 15 μL, or less than about 10μL, or less than about 5 μL, or less than about 4 μL, or less than about3 μL, or less than about 2 μL, or less than about 1 μL, or less, themethod comprising placing a sample within said internal cavity of saidsample container, and performing the sample analysis.

In embodiments of the methods of sample analysis disclosed herein, thesample containers, or inserts placed therein, comprise internal cavitiescomprising a bevel in the bottom portion of an insert cavity, whereinthe cross-sectional shape of said bevel comprises a triangular,circular, hemispherical, oval, elliptical, or other shape. Inembodiments of the methods of sample analysis disclosed herein, thesample containers, or inserts placed therein, comprise internal cavitiescomprising an angle effective to provide a taper in at least an upperportion, or a lower portion, or both, of a wall of said internal cavity,wherein the taper comprises tapers selected from tapers in which theupper taper the same as the lower taper; the upper taper is differentthan the lower taper; tapers which become narrower towards the lowerportion; and tapers which become wider towards the lower portion. Inembodiments of the methods of sample analysis disclosed herein, thesample containers, or inserts placed therein, comprise internal cavitiescomprising a bevel, a wall, a floor, and a wall angle formed by saidwall and said bevel, wherein the wall angle comprises an angle ofbetween about 80° to about 40°, or between about 65° to about 45°; infurther embodiments, the internal cavity comprises a floor angle formedby the floor and the bevel, and the wall angle is complementary to thefloor angle.

In embodiments of the methods of sample analysis disclosed herein, thesample containers, or inserts placed therein, comprise internal cavitiescomprising a depth and a width, wherein the ratio of the depth to thewidth is between about 0.1:1 to about 10:1; between about 0.2:1 to about5:1; or between about 0.5:1 to about 3:1; or may be about 0.3:1; or maybe about 0.5:1; or may be about 0.8:1; or may be about 1:1; or may beabout 1.2:1; or may be about 1.5:1; or may be about 1.8:1; or may beabout 2:1; or may be about 3:1; or may be about 4:1; or may be about5:1; or may be about 6:1; or may be about 8:1; or may be another ratio.

In embodiments of the methods of sample analysis disclosed herein, theinternal cavity comprises an internal cavity selected from the groupconsisting of the internal cavity of an insert, wherein said insert isdisposed within the cavity of an original sample container; the internalcavity of a replacement sample container; and the internal cavity ofanother sample container.

In embodiments of the methods of sample analysis disclosed herein, thesample that is analyzed may comprise a portion of sample that wasobtained from a subject. Thus, a small volume of sample may be obtainedby obtaining a small-volume sample from a subject, or by obtaining asmall volume aliquot of a sample (which sample may itself be asmall-volume sample). In embodiments, small volumes of sample may bediluted to provide larger total volumes for analysis, e.g., for analysisin automatic sample analysis devices or automatic sample analysissystems. Such dilution may be performed prior to placing the sample, oraliquot thereof, in an automatic sample analysis device or system; ormay be performed by or within an automatic sample analysis device orsystem prior to analysis of the sample or aliquot thereof.

In embodiments, the methods are performed on diluted samples, oraliquots thereof, and comprise modifications of one or more steps ofsuch assays, where such modifications take into account differences insample volume and concentration, or differences in reagent volume orconcentration, or both, as compared to such assays and assays stepsotherwise configured for use with samples that have not been diluted.Thus, for example, one or more steps of assays suitable for use withsamples that have not been diluted may be modified for use with dilutedsamples, or aliquots of diluted samples. An amount of dilution may bedefined by a ratio of (diluted volume):(original volume). Inembodiments, a dilution of a sample, including dilution of asmall-volume fluid sample, may be dilution that is greater than about2:1; or greater than about 3:1; or greater than about 4:1; or greaterthan about 5:1; or greater than about 10:1; or greater than about 20:1;or greater than about 30:1; or greater than about 40:1; or greater thanabout 50:1; or greater than about 100:1; or greater than about 200:1; orgreater than about 300:1; or greater than about 400:1; or greater thanabout 500:1; or greater than about 1000:1; or greater than about 2000:1;or greater than about 4000:1; or greater than about 5000:1; or greaterthan about 10000:1; or greater.

In embodiments, modification of a step or steps may include, withoutlimitation, modification of the duration or timing of a step (e.g.,delay before performing a step, or duration of a step, or other timeparameter associated with a step); may include modification of thesequence (e.g., ordering) of steps; may include deleting a step orcombining two or more steps together; may include modification ofdetection method, intensity of illumination, incubation temperature,reaction temperature, or other parameter or combination of parameters ofone or more steps of an assay. In embodiments, for example, one or morereagents for use in assays suitable for use with samples that have notbeen diluted may be modified for use with diluted samples, or aliquotsof diluted samples. In embodiments, modification of a reagent orreagents may include without limitation, modification of theconcentration(s) of one or more constituent(s) of the reagent; mayinclude the combination of two or more reagents; may include eliminationof one or more constituent(s) of the reagent; may include adding one ormore constituent(s) to the reagent; may include modification of theratio of concentration(s) of two or more constituent(s) of the reagent;or other modifications.

An automatic sample analysis device or system may be modified, e.g., byproviding an insert, to accept a small-volume sample, or aliquot of asample, and to analyze the sample or aliquot for the presence or absenceof an analyte, or of a plurality of analytes. In embodiments, anautomatic sample analysis device or system may analyze such a sample, ora calibration reagent, or both. A sample, or aliquot thereof, may bediluted when provided to an automatic sample analysis device or system.A sample, or aliquot thereof, may be provided undiluted to an automaticsample analysis device or system. A sample, or aliquot thereof, may bediluted by an automatic sample analysis device or system. A calibrationreagent may be provided undiluted to an automatic sample analysis deviceor system, or may be diluted to the same extent as a diluted sample whenprovided to an automatic sample analysis device or system. A calibrationreagent may be diluted by an automatic sample analysis device or systemfor use with a diluted sample; when diluted, a calibration reagent isdiluted to the same extent as a diluted sample, or in a known ratio orknown relation to the amount of dilution of the sample.

Applicant discloses methods of analyzing a small-volume fluid samplewith a sample analysis device having a sample container configured foruse with a fluid sample having a volume of no less than a first volume,wherein said small-volume sample has a second volume smaller than saidfirst volume, wherein analysis by said sample analysis device requiresthat a sample be held within said sample container during at least aportion of the performance of said analysis, the sample container havingan internal cavity having an original volume, the methods comprising:Placing an insert within said internal cavity of the sample container,wherein said insert has an insert cavity having a volume of less thansaid original volume, and wherein said insert cavity is configured tohold a small-volume fluid sample, Placing said small-volume fluid samplewithin said insert cavity, and Analyzing the small-volume sample withsaid sample analysis device.

Applicant discloses methods of analyzing a small-volume fluid samplewith a sample analysis device having a sample container configured foruse with a fluid sample having a volume of no less than a first volume,wherein said small-volume sample has a second volume smaller than saidfirst volume, wherein analysis by said sample analysis device requiresthat a sample be held within said sample container during at least aportion of the performance of said analysis, the sample container havingan internal cavity having an original volume, the methods comprising:Placing an insert within said internal cavity of the sample container,wherein said insert comprises an insert cavity for holding said samplehaving a volume of less than said original volume, said insert cavitycomprising a bevel, a wall, a floor, and a wall angle formed by saidwall and said bevel, wherein the wall angle comprises an angle ofbetween about 80° to about 40°, or between about 65° to about 45°,Placing said small-volume fluid sample within said insert cavity, andAnalyzing the small-volume sample with said sample analysis device. Inembodiments, such a method further comprises diluting said small-volumefluid sample prior to placing the small-volume fluid sample in theinsert cavity of said insert, wherein said dilution is effective toincrease the volume of the diluted sample to a third volume, whereinsaid third volume is greater than said second volume. In embodiments,where dilution is defined by a ratio of (diluted volume):(originalvolume), such a dilution may be dilution greater than about 2:1; orgreater than about 3:1; or greater than about 4:1; or greater than about5:1; or greater than about 10:1; or greater than about 20:1; or greaterthan about 30:1; or greater than about 40:1; or greater than about 50:1;or greater than about 100:1; or greater than about 200:1; or greaterthan about 300:1; or greater than about 400:1; or greater than about500:1; or greater than about 1000:1; or greater than about 2000:1; orgreater than about 4000:1; or greater than about 5000:1; or greater thanabout 10000:1; or greater.

In embodiments, the insert cavity has a dead volume, wherein the deadvolume has a volume less than about 200 μL, or less than about 100 μL,or less than about 50 μL, or less than about 30 μL, or less than about20 μL, or less than about 15 μL, or less than about 10 μL, or less thanabout 5 μL, or less than about 4 μL, or less than about 3 μL, or lessthan about 2 μL, or less than about 1 μL. In embodiments, the insertcavity comprises a depth and a width, wherein the ratio of the depth tothe width is between about 0.1:1 to about 10:1; between about 0.2:1 toabout 5:1; or between about 0.5:1 to about 3:1; or may be about 0.3:1;or may be about 0.5:1; or may be about 0.8:1; or may be about 1:1; ormay be about 1.2:1; or may be about 1.5:1; or may be about 1.8:1; or maybe about 2:1; or may be about 3:1; or may be about 4:1; or may be about5:1; or may be about 6:1; or may be about 8:1. In embodiments, theinsert cavity comprises a bevel in the bottom portion of said insertcavity, wherein the cross-sectional shape of said bevel comprises atriangular, circular, hemispherical, oval, or elliptical shape. Inembodiments, the insert cavity comprises a depth and a width, whereinthe ratio of the depth to the width is between about 0.1:1 to about10:1; between about 0.2:1 to about 5:1; or between about 0.5:1 to about3:1; or may be about 0.3:1; or may be about 0.5:1; or may be about0.8:1; or may be about 1:1; or may be about 1.2:1; or may be about1.5:1; or may be about 1.8:1; or may be about 2:1; or may be about 3:1;or may be about 4:1; or may be about 5:1; or may be about 6:1; or may beabout 8:1.

Applicant discloses methods of analyzing a small-volume fluid samplewith a sample analysis device having a sample container configured foruse with a fluid sample having a volume of no less than a first volume,wherein said small-volume sample has a second volume smaller than saidfirst volume, wherein analysis by said sample analysis device requiresthat a sample be held within said sample container during at least aportion of the performance of said analysis, the sample container havingan internal cavity having an original volume, the methods comprising:Diluting said small-volume fluid sample prior to placing thesmall-volume fluid sample in the insert cavity of said insert, whereinsaid dilution is effective to increase the volume of the diluted sampleto a third volume, wherein said third volume is greater than said secondvolume, Placing an insert within said internal cavity of the samplecontainer, wherein said insert comprises an insert cavity for holdingsaid sample having a volume of less than said original volume, saidinsert cavity comprising a bevel, a wall, a floor, and a wall angleformed by said wall and said bevel, wherein the wall angle comprises anangle of between about 80° to about 40°, or between about 65° to about45°, Placing said small-volume fluid sample within said insert cavity,and Analyzing the small-volume sample with said sample analysis device.

In embodiments of the methods of sample analysis disclosed herein,sample analysis may comprise processing a sample, analyzing a sample, orboth processing a sample and analyzing a sample.

Applicant provides methods for modifying a clinical analysis devicecomprising reducing the sample volume by placing an insert in a sampleholder. Applicant provides methods for modifying a clinical analysisdevice comprising reducing the sample volume by placing an insert in asample holder, and increasing the sensitivity of a detector. Applicantprovides methods for modifying a clinical analysis device comprisingreducing the sample volume by placing an insert in a sample holder, anddecreasing the distance between a sample and a detector. Applicantprovides methods for modifying a clinical analysis device comprisingreducing the sample volume by placing an insert in a sample holder, andincreasing the intensity of an illumination source providingillumination of a sample to be detected by a detector. Applicantprovides methods for modifying a clinical analysis device comprisingreducing the volume of a sample container by placing an insert into saidsample container; and increasing the concentration of a dye or of asubstrate which is detected by, or which provides a signal detected by,a detector during operation of the device. Applicant provides methodsfor modifying a clinical analysis device comprising diluting a sample,and: increasing the sensitivity of a detector; or increasing theintensity of an illumination source providing illumination of a sampleto be detected by a detector; or increasing the concentration of adye/substrate which is detected by a detector during operation of thedevice.

Accordingly, Applicant provides a method for reducing the volume ofsample used in the performance of an assay as compared to an originalvolume of sample used for the original performance of said assay,wherein said assay comprises the detection of an optical signal fordetection of the presence of, or quantification of, a target substancein a sample, the method comprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the intensity of illumination applied to said sample,        as compared to the original intensity of illumination applied to        the sample, wherein said illumination is used to detect the        presence of said target substance in the sample, or to quantify        the amount of said target substance in the sample.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of a fluorescent label for detection ofthe presence of, or quantification of, a target substance in a sample,the method comprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the intensity of light illuminating the sample and        assay reagents during fluorescence measurements, as compared to        the original intensity of light illuminating the sample and        assay reagents during fluorescence measurements, wherein said        fluorescence measurements are used to detect the presence of        said target substance in the sample, or to quantify the amount        of said target substance in the sample.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of a dye for detection of the presence of,or quantification of, a target substance in a sample, the methodcomprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the concentration of dye added to the sample, as        compared to the original concentration of dye added to the        sample, wherein said dye labels a target substance in the        sample. In embodiments, increasing the concentration of a dye        added to the sample comprises increasing the amount of dye added        to the sample, as compared to the original amount of dye added        to the sample.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of an enzymatic label for detection of thepresence of, or quantification of, a target substance in a sample, themethod comprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the concentration of substrate added to the sample in        the presence of the enzyme prior to, or during, enzymatic label        measurements, as compared to the original concentration of        substrate added to the sample, wherein said enzymatic label        measurements are indicative of the presence of, or quantities        of, target substance in the sample.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of a labeled antibody for detection of thepresence of, or quantification of, a target substance in a sample, themethod comprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the concentration of labeled antibody added to the        sample, as compared to the original concentration of labeled        antibody added to the sample, wherein said antibody binds a        target substance in the sample. In embodiments, increasing the        concentration of a labeled antibody added to the sample        comprises increasing the amount of labeled antibody added to the        sample, as compared to the original amount of labeled antibody        added to the sample.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of a labeled antibody for detection of thepresence of, or quantification of, a target substance in a sample, themethod comprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the number of labels per labeled antibody added to        the sample, as compared to the original number of labels per        labeled antibody added to the sample, wherein said antibody        binds a target substance in the sample.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of an optical signal produced by a targetsubstance, or by a reagent which binds to or reacts with said targetsubstance, the assay being useful for detection of the presence of, orquantification of, the target substance in a sample, the methodcomprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the sensitivity of an optical detector used to detect        said optical signal, as compared to the original sensitivity of        the optical detector used to detect the optical signal.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of an optical signal produced by a targetsubstance, or by a reagent which binds to or reacts with said targetsubstance, the assay being useful for detection of the presence of, orquantification of, the target substance in a sample, the methodcomprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Decreasing the separation between the sample and an optical        detector used to detect said optical signal, as compared to the        original separation between the sample and the optical detector        used to detect the optical signal.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of an optical signal produced by a targetsubstance, or by a reagent which binds to or reacts with said targetsubstance, the assay being useful for detection of the presence of, orquantification of, the target substance in a sample, the methodcomprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the path length within the sample between a source of        illumination and through the sample to an optical detector used        to detect said optical signal, as compared to the original path        length within the sample between a source of illumination and        through the sample to an optical detector used to detect the        optical signal. In embodiments, the path length within the        sample is increased, as compared to the original path length        within the sample, by alteration of the container holding the        sample. In further embodiments, the path length within the        sample is increased, as compared to the original path length        within the sample, by reflection or refraction of light within        the container holding the sample.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of an optical signal produced by a targetsubstance, or by a reagent which binds to or reacts with said targetsubstance, the assay being useful for detection of the presence of, orquantification of, the target substance in a sample, the methodcomprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Altering the wavelength of light passing through said sample and        to an optical detector used to detect the optical signal, as        compared to the original wavelength of light passing through the        sample and to an optical detector used to detect the optical        signal. In embodiments, altering the wavelength of light passing        through said sample and to an optical detector used to detect        the optical signal comprises providing multiple wavelengths of        light passing through the sample and to an optical detector.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of an optical signal produced by a targetsubstance, or by a reagent which binds to or reacts with said targetsubstance, the assay being useful for detection of the presence of, orquantification of, the target substance in a sample, the methodcomprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Altering the polarization of light passing through said sample        and to an optical detector used to detect the optical signal, as        compared to the original polarization of light passing through        the sample and to an optical detector used to detect the optical        signal. Applicants further provide a method for reducing the        volume of sample used in the performance of an assay as compared        to an original volume of sample used for the original        performance of said assay, wherein said assay comprises the        detection of an electrical signal indicative of the presence of,        or quantification of, the target substance in a sample, the        method comprising:    -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Increasing the electronic amplification of said electrical        signal, as compared to the original electronic amplification of        the electrical signal. In embodiments, the electrical signal is        produced by the target substance, or by a reagent which binds to        or reacts with said target sub stance.

Applicants further provide a method for reducing the volume of sampleused in the performance of an assay as compared to an original volume ofsample used for the original performance of said assay, wherein saidassay comprises the detection of a signal indicative of the presence of,or quantification of, the target substance in a sample, wherein saidsignal comprise a temperature-sensitive signal, the method comprising:

-   -   Reducing the volume of sample used in the assay from a first        sample volume to a second sample volume, wherein said second        sample volume is less than said first sample volume, and wherein        the assay was originally performed using said first volume of        sample; and    -   Altering the temperature of the assay. In embodiments, the        temperature-sensitive signal is increased with increasing        temperature, and wherein altering the temperature of the assay        comprises increasing the temperature of the assay. In further        embodiments, the temperature of said original performance of        said assay was near 20° C., and wherein said altered assay        temperature is selected from about 25° C., about 30° C., about        32° C., about 34° C., about 35° C., about 36° C., about 37° C.,        about 38° C., about 39° C., and about 40° C.

In any of the foregoing methods, the sample may be contained within asample container during at least a portion of the performance of saidoriginal assay, said sample container comprising an internal cavity forholding said sample, said internal cavity having a volume, and whereinany of the foregoing methods comprise reducing said volume of saidinternal cavity. In embodiments, reducing the volume of said internalcavity comprises providing replacement sample container, or analternative (e.g., a substitute) sample container. In embodiments,reducing the volume of said internal cavity comprises placing an insertinto said internal cavity. In embodiments, an insert may comprise aninsert cavity configured to hold said sample, wherein said insert cavitycomprises a volume less than said internal cavity volume. Inembodiments, an insert may comprise an insert cavity configured toretain less sample after draining as compared to the amount of sampleretained in an original sample container after draining. In embodiments,an insert may be configured effective that optical signals indicative ofthe presence of, or quantification of, a target substance in a samplecontained within said insert may be detected by said optical detector.

In embodiments, a detector may be disposed outside a sample container,e.g., disposed in a location that is external to the sample container.For example, an optical detector may be disposed in a location that isexternal to a sample container. In embodiments, a detector may bedisposed, at least partially, within a sample container, e.g., a tipportion, or other portion, disposed within a sample container (e.g.,within an insert cavity of a sample container). In embodiments, afiber-optical conduit may direct light to an optical detector; such afiber-optical conduit may have an end, e.g., a tip, that is configuredto receive light emitted from, or passing through, a sample container.In embodiments, a fiber-optical conduit may have an end, e.g. a tip,that is disposed outside of a sample container, e.g., in a location thatis external to the sample container. In embodiments, a fiber-opticalconduit may have an end, e.g. a tip, that is disposed within a samplecontainer, e.g., within an insert cavity of a sample container. Inembodiments, a fiber-optical conduit may have an end, e.g. a tip, thatis disposed at least partially within a sample container, e.g., at leastpartially within an insert cavity of a sample container.

Applicants disclose herein devices for reducing the volume of sampleheld within a sample container, wherein the sample container isconfigured to hold a first volume of sample effective to allow detectionof a target substance in the sample by a detector disposed externally tothe sample container, wherein the device comprises an insert configuredto i) fit within the sample container, ii) hold a second volume ofsample, wherein the second volume of sample is less than the firstvolume of sample, and iii) allow the detection of a signal indicative ofthe presence of, or quantification of, a target substance in a samplecontained within the insert, wherein the detection comprises detectionby a detector, wherein at least a portion of the detector is disposedwithin the sample container. For example, such a detector may have a tipportion, and the tip portion of the detector may be disposed inside thesample container. In embodiments, such a detector may be, for example,an ion-selective electrode (e.g., a sodium selective electrode, apotassium-selective electrode, a chloride-selective electrode, or otherion-selective electrode); a voltammetric probe; a amperometric probe; orother detector configured to be placed within the sample container, orconfigured for at least a portion of the detector, to be placed withinthe sample container.

Practice of these methods provides surprising results. For example,devices designed to use large volume samples (e.g., volumes on the orderof tens of milliliters, or even on the order of one or a fewmilliliters) may be modified to provide results using only smallfractions of a milliliter, or even only a few microliters of sample.Practice of the methods disclosed herein, and use of the devicesdisclosed herein, allows detection of target analytes in very smallsamples; this is surprising since previously available devices, systems,assays, and techniques required much larger sample volumes. In addition,use of small-volume samples may allow detection of target analyteswithin short periods of time, including within periods of time shorterthan the times required using unmodified devices and systems.

Accordingly, improved methods for detecting, identifying,characterizing, and measuring one or more analytes in a sample in anautomatic sample analysis device are provided. In embodiments, theimproved methods provide improved methods for detecting, identifying,characterizing, and measuring one or more analytes in a diluted sample,or in multiple portions of a diluted sample, in an automatic sampleanalysis device. In embodiments, these methods may be performed in ashort period of time, and may be performed on small-volume samples. Themethods disclosed herein provide advantages by requiring only a smallamount of sample to be collected from a subject; by requiring only ashort period of time perform an assay; by performing multiple assaysfrom a single sample; by performing multiple assays in a singleautomatic sample analysis device; and by providing other advantages andimprovements.

Practice of these methods provides advantages over previous methods anddevices by requiring smaller volumes of reagents as well as smallervolumes of sample. Thus, the methods and devices disclosed hereinprovide synergistic advantages, in that by reducing the sample volumerequired, reagent volumes are also reduced, assay cost is reduced,discomfort to the subject (from whom the sample is obtained) is reduced,and waste resulting from the performance of the assays is reduced.Accordingly, the present methods and devices are useful and providesurprising advantages for assays for detecting analytes in a sample.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 provides an illustration of an insert configured to fit within asample container.

FIG. 2A shows a perspective view of an insert having features asdisclosed herein.

FIG. 2B shows a cross-section of an insert as shown in FIG. 2A, showingthe insert cavity and illustrating an example of a bevel in the floor ofan insert suitable for enhancing fluid flow and for reducing the volumeof an insert cavity.

FIG. 3A provides an illustration of a system including an analysisdevice, a sample container, and an insert configured to fit within thesample container. The sample is held in the insert cavity of the insert,and so a smaller amount of sample is used than would be used in theabsence of the insert. Such a system is able to analyze a smaller samplethan would otherwise be required in the absence of the insert placed inthe sample container.

FIG. 3B provides an illustration of a system including an analysisdevice, a sample container, and an insert configured to fit within theanalysis device, in place of a sample container. Such a system is ableto analyze a smaller sample than it would otherwise be able to do in theabsence of the insert, which is used to hold the sample during analysisinstead of the sample container.

DETAILED DESCRIPTION

Description and disclosure of examples of reagents, assays, methods,kits, devices, and systems which may be used with the methods, assays,reagents, devices and systems disclosed herein may be found, forexample, in U.S. Patent Application Ser. No. 61/993,566 filed May 15,2014; U.S. Patent Application Ser. No. 61/888,318 filed Oct. 8, 2013;U.S. Patent Application Ser. No. 61/875,678 filed Sep. 9, 2013; U.S.Patent Application Ser. No. 61/858,589 filed Jul. 25, 2013; U.S. Pat.Nos. 8,380,541; 8,088,593; U.S. patent application Ser. No. 13/769,798,filed Feb. 18, 2013; U.S. patent application Ser. No. 13/769,779, filedFeb. 18, 2013; PCT/US2012/57155, filed Sep. 25, 2012; U.S. patentapplication Ser. No. 13/244,949, filed Sep. 26, 2011; U.S. PatentApplication Ser. No. 61/800,606, filed Mar. 15, 2013; U.S. PatentApplication Ser. No. 61/766,095, filed Feb. 18, 2013; and U.S. PatentApplication Ser. No. 61/673,245, filed Sep. 26, 2011, the disclosures ofwhich patents and patent applications are all hereby incorporated byreference in their entireties.

Definitions

As used herein, the term “original volume” and grammatical variantsthereof refer to the sample volume used in an assay, or in an assaydevice, prior to modification or alteration of the assay method, orassay device.

As used herein, the term “reduced volume” and grammatical variantsthereof refer to the sample volume used in an assay, or in an assaydevice, following modification or alteration of the assay method, orassay device, where such modification and alteration reduce the samplevolume as compared to the original volume.

As used herein, the term “dead volume” and grammatical variants thereofrefer to the residual volume of sample remaining in a container afterthe container has been drained of sample by normal operation of a deviceor system; thus, the portion of a sample that effectively cannot beremoved from a sample container (or insert cavity placed in a samplecontainer) by normal operation of a device or system, or by normalmethods, comprises the dead volume of that sample container or insert.(Although application of high pressure air or steam, or extraction witha series of solvents, or other heroic measures (which typically destroythe sample and analytes in it) might “remove” more of the sample, theneed for such methods to remove the remaining sample indicates that theremaining sample indeed effectively cannot be removed by normaloperations or methods.)

Thus, a volume of sample may remain in a sample container after drainingthe container. Applicants disclose herein methods and devices which areuseful for reducing the volume of sample which remains after draining,e.g., to a small volume of sample.

Thus, as disclosed herein, it is desirable to reduce the amount ofsample remaining in a sample container (after draining the container) toa small volume of sample. In embodiments, such a small volume of samplemay comprise less than about 50 μL, less than about 40 μL, less thanabout 30 μL, or less than about 25 μL, less than about 20 μL, or lessthan about 15 μL, or less than about 10 μL, or less than about 5 μL, orless than about 4 μL, or less than about 3 μL, or less than about 2 μL,or less than about 1 μL, or less.

The word “label” or “marker” or the phrases “detectable label” and“marker moiety” when used herein refer to a detectable compound orcomposition which is conjugated directly or indirectly to the antibodyso as to generate a “labeled” antibody. The label may be detectable byitself (e.g. radioisotope labels or fluorescent labels) or, in the caseof an enzymatic label, may catalyze chemical alteration of a substratecompound or composition which is detectable. A label may be, withoutlimitation, a dye, an epitope tag, a fluorescent moiety, a luminescentmoiety, a chemiluminescent moiety, an enzymatic label, a magnetic label,a paramagnetic label, a contrast agent, a nanoparticle, a radioisotope,biotin, streptavidin, and a quencher.

A label may be an alkaline phosphatase label, in which the results of areaction catalyzed by alkaline phosphatase is observed, and may be usedto identify an analyte or verify its presence in a sample, and may beused to quantify an analyte in a sample. Alkaline phosphatase reagentsare commercially available; for example, Nitroblue Tetrazolium (NBT) isused with the alkaline phosphatase substrate 5-Bromo-4-Chloro-3-IndolylPhosphate (BCIP) to provide a colored product which may be observed andquantitated. Other reagents include Fast Red TR/Naphthol AS-MX and TRphosphate (4-Chloro-2-methylbenzenediazonium/3-Hydroxy-2-naphthoic acid2,4-dimethylanilide phosphate, reagents for the production ofp-nitrophenol, and others.

For example, a label may be a peroxidase label (such as horseradishperoxidase, myeloperoxidase, or other peroxidase) in which the resultsof a reaction catalyzed by the peroxidase is observed, and may be usedto identify an analyte or verify its presence in a sample, and may beused to quantify an analyte in a sample. Benzidine-containing compounds(e.g., diaminobenzidine, tetramethyl benzidine), aniline-containingcompounds, aminoantipyrene compounds, Trinder reagents, and otherreagents known in the art may be used to provide a detectable product inthe presence of a peroxidase.

A label may be a dye, such as rhodamine and related rhodamine dyes(e.g., tetramethylrhodamine (TMR), carboxytatramethyl rhodamine (TAMRA),and others), fluorescein and fluorescein derivatives (e.g.,5-carboxyfluorescein, 6-carboxy fluorescein and others), phycoerythrin,umbelliferone, Texas Red, rare earth chelates (europium chelates),dansyl dyes (including, e.g., dansylamide dyes, dansyl cadaverine,dansyl chloride, and others); cyanine dyes (e.g., Cy3, Cy5, SYBR green,and others); Lissamine; phycoerythrins; Texas Red; and analogs thereof.

A label may be a fluorescent material, including fluorescent dyes, andincluding green fluorescent protein and other fluorescent proteins knownin the art. A label may be a luminescent moiety, such as luminol, orother luminescent material, including bioluminescent materials such asluciferase, luciferin, and aequorin.

A label may be a nanoparticle, such as a gold nanoparticle (e.g., acolloidal gold particle), or a quantum dot (e.g., a small particle,typically a semiconductor, which may be detectable upon application ofan appropriate amount and wavelength of electromagnetic radiation, e.g.,by illumination). A label may be a magnetic label, or a paramagneticlabel, which may be a nanoparticle or bead. A label may be aradioisotope or other radioactive material, including, e.g., ¹³¹I, ¹²⁵I,¹¹¹In, ⁹⁹Tc, ³⁵S, ¹⁴C, and ³H.

The term “quench” or “quenching” is used to indicate a reduction indetectable emission radiation, e.g., fluorescent or luminescentradiation, from a source that would otherwise have emitted thisradiation. Quenching is a reduction of at least 50%, preferably 80% andmore preferably 90%, of the detectable radiation from the source.

The term “quenchable dye” as used herein is a single molecular speciesthat emits detectable radiation when in solution or bound to asingle-stranded oligomer, either directly or through a linking moiety.The detectable radiation of a quenchable dye bound directly to asingle-stranded oligomer is reversibly quenched upon hybridization ofthe oligomer to a complementary oligonucleotide to form a hybrid duplexor triplex. No additional molecular species, e.g., a quenching dye, isrequired for the quenching to occur. However, if the quenchable dye isbound to the oligomer through a linker moiety, hybridization of theoligomer to its complement will not result in quenching of thedetectable radiation emitted by the dye.

Fluorescent dyes that intercalculate with double-stranded DNA include,for example, SYBR Gold™, SYBR Green I™, SYBR Green II™, ethidiumbromide, BlueView™ methylene blue, DAPI, DRAQ5 and related dyes, andacridine orange. Other fluorophores include, but are not limited to7-dimethylaminocoumarin-3-carboxylic acid, dansyl chloride,nitrobenzodiazolamine (NBD), dabsyl chloride, cinnamic acid, fluoresceincarboxylic acid, Nile Blue, tetramethylcarboxyrhodamine,tetraethylsulfohodamine, 5-carboxy-X-rhodamine (5-ROX), and6-carboxy-X-rhodamine (6-ROX). Quenchers that may be used include, forexample, DDQ-I, DDQ-II (Eurogentec), Eclipse (Epoch Biosciences), IowaBlack FQ, Iowa Black RQ (Integrated DNA Technologies), BHQ-1, BHQ-2,BHQ-3 (Biosearch Technologies), QSY-7, QSY-21 (Molecular Probes), andDabcyl.

Dyes include, for example, CAL Fluor Gold, CAL Fluor Orange, Quasar 570,CAL Fluor Red 590, CAL Fluor Red 610, CAL Fluor Red 610, CAL Fluor Red635, Quasar 670 (Biosearch Technologies), VIC, NED (Life Technologies),Cy3, Cy5, Cy5.5 (GE Healthcare Life Sciences), Oyster 556, Oyster 645(Integrated DNA Technologies), LC red 610, LC red 610, LC red 640, LCred 670, LC red 705 (Roche Applies Science), Texas red, FAM, TET, HEX,JOE, TMR, and ROX. Non-limiting examples of near infrared dyes that canbe conjugated to the antibodies, fragments, and/or derivatives of thepresently disclosed subject matter include NIR641, NIR664, NIT7000, andNIT782. fluorescent label including, but not limited to Cy3, Cy5, Cy7,and any of the ALEXA FLUOR® series of fluorescent labels.

Signals indicative of the presence or absence, or of the amount, of ananalyte or of multiple analytes in a sample, may be optical signals.Optical signals may be detected, and may be measured, by opticaldetectors, which may include spectrophotometers, photomultiplier tubes,charge-coupled devices, photodiodes, avalanche photodiodes, avalanchephotodiode arrays, pin diodes, digital cameras, and other opticaldevices and optical detection means.

As used herein, the term “antibody” is used in the broadest sense andspecifically covers single monoclonal antibodies (including agonist andantagonist antibodies) and antibody compositions with polyepitopicspecificity. Thus, antibodies may be polyclonal antibodies, e.g., may beantibodies purified from the blood of an animal such as a sheep or goatwhich has been challenged by a target antigen, and may be monoclonalantibodies. For example, monoclonal antibodies may be made by thehybridoma method first described by Kohler et al., Nature, 256:495(1975), or may be made by recombinant DNA methods (see, e.g., U.S. Pat.No. 4,816,567 to Cabilly et al.). The “monoclonal antibodies” alsoinclude clones of antigen-recognition and binding-site containingantibody fragments (Fv clones) isolated from phage antibody librariesusing the techniques described in Clackson et al., Nature, 352:624-628(1991) and Marks et al., J. Mol. Biol., 222:581-597 (1991), for example.Monoclonal antibodies are obtained from a population of substantiallyhomogeneous antibodies, i.e., the individual antibodies comprising thepopulation are identical except for possible naturally-occurringmutations that may be present in minor amounts.

Antibodies (e.g., IgG antibodies) are usually heterotetramericglycoproteins of about 150,000 daltons, composed of two identical lightchains (LCs) and two identical heavy chains (HCs). Each light chain islinked to a heavy chain by one covalent disulfide bond, while the numberof disulfide linkages varies between the heavy chains of differentimmunoglobulin isotypes. Each heavy and light chain also has regularlyspaced intrachain disulfide bridges between cysteines. Each heavy chainhas at a variable domain, followed by a number of constant domains. Thevariable domains are disposed closer to the amino-terminal (N-terminal)portion of the HC than are the constant domains; conversely, theconstant domains are disposed closer to the carboxy-terminal(C-terminal) portion of the HC than are the variable domains. Similarly,each light chain has a variable domain at one end (towards theN-terminal) and a constant domain at its other end (towards theC-terminal); the constant domain of the light chain is aligned with thefirst constant domain of the heavy chain, and the light chain variabledomain is aligned with the variable domain of the heavy chain.Particular amino acid residues are believed to form an interface betweenthe light- and heavy-chain variable domains (Clothia et al., J. Mol.Biol. 186:651 (1985); Novotny and Haber, Proc. Natl. Acad. Sci. U.S.A.82:4592 (1985)). The variable domains form the antigen-binding sites;thus an intact antibody has two antigen binding sites composed ofvariable domains of the LC and HC pairs.

“Antibody fragment”, and all grammatical variants thereof, as usedherein are defined as a (1) portion of an intact antibody comprising theantigen binding site or variable region of the intact antibody, whereinthe portion is free of the constant heavy chain domains (i.e. CH2, CH3,and CH4, depending on antibody isotype) of the Fc region of the intactantibody, and (2) constructs comprising a portion of an intact antibody(as defined by the amino acid sequence of the intact antibody)comprising the antigen binding site or variable region of the intactantibody. Examples of antibody fragments include Fab, Fab′, Fab′-SH,F(ab′)₂, Fd, Fc, Fv, diabodies, and any other “Non-single-chainantigen-binding unit” as described, e.g., in U.S. Pat. No. 7,429,652.The term “intact antibody” refers to the complete antibody, or the aminoacid sequence of the complete antibody, of which an antibody fragment isa part. It will be understood that an antibody fragment may be producedby partial digestion (e.g., by papain or pepsin) of an intact antibody,or may be produced by recombinant or other means.

As used herein, a “labeled antibody” refers to an antibody (whetherintact or an antibody fragment) which is detectable by way of a labelattached to the antibody. Such a label may be covalently attached to theantibody; such a label may be a dye, a radioisotope, a recognizableepitope (e.g., an epitope tag), or other label. A labeled antibody mayinclude one, or may include multiple labels; multiple labels may behomogeneous or may be heterogeneous (e.g., a labeled antibody may have aplurality of fluorescent moieties covalently linked to the antibody(homogeneous) or may have a fluorescent moiety and a radioactive moietylinked to the antibody (heterogeneous)).

As used herein, the term “substantial” means more than a minimal orinsignificant amount; and “substantially” means more than a minimally orinsignificantly. Thus, for example, the phrase “substantially the same”,as used herein, denotes a sufficiently high degree of similarity betweentwo numeric values such that one of skill in the art would consider thesimilarity between the two values to be of statistical significancewithin the context of the characteristic measured by said values. Thus,two values that are substantially the same as each other is typicallyless than about 20%, and may be less than about 10%, preferably lessthan about 5%, and may be less than about 4%, as a function of thereference value or comparator value.

As used herein, the terms “equivalently diluted”, “equivalent dilution”,and the like refer to two or more diluted solutions, for which the ratioof the original volume to the final volume of the first solution is thesame as the ratio of the original volume to the final volume of thesecond (and subsequent) solution or solutions. Thus, two solutions whichare equivalently diluted are each diluted by the same ratio (as comparedto the original solution volume); such solutions may be described ashaving been diluted by same dilution factor. For example, where a 100 μLsample is diluted to provide 1 mL of diluted sample (i.e., diluted by afactor of 10), an equivalently diluted calibrator is a calibrator thatis diluted by a factor of 10 (e.g., a 1 mL calibrator solution that isdiluted to provide 10 mL of diluted calibrator).

As used herein, the term “biological sample” refers to a fluid, tissue,or other material collected from a subject. Examples of biologicalsamples can include but are not limited to, blood, serum, plasma, anasal swab, a nasopharyngeal wash, saliva, urine, gastric fluid, spinalfluid, tears, stool, mucus, sweat, earwax, oil, a glandular secretion,cerebral spinal fluid, tissue, semen, vaginal fluid, interstitial fluidsderived from tumorous tissue, ocular fluids, spinal fluid, a throatswab, breath, hair, finger nails, skin, biopsy, placental fluid,amniotic fluid, cord blood, lymphatic fluids, cavity fluids, sputum,pus, microbiota, meconium, breast milk and/or other excretions.Biological samples may include nasopharyngeal wash, or other fluidobtained by washing a body cavity or surface of a subject, or by washinga swab following application of the swab to a body cavity or surface ofa subject. Nasal swabs, throat swabs, stool samples, hair, finger nail,ear wax, breath, and other solid, semi-solid, or gaseous samples may beprocessed in an extraction buffer, e.g., for a fixed or variable amountof time, prior to their analysis. The extraction buffer or an aliquotthereof may then be processed similarly to other fluid samples ifdesired. Examples of tissue samples of the subject may include but arenot limited to, connective tissue, muscle tissue, nervous tissue,epithelial tissue, cartilage, cancerous sample, or bone. The sample maybe provided from a human or animal. The sample may be provided from amammal, vertebrate, such as murines, simians, humans, farm animals,sport animals, or pets. The sample may be collected from a living ordead subject. The sample may be collected fresh from a subject or mayhave undergone some form of pre-processing, storage, or transport.

A sample may be, for example, a bodily fluid sample obtained from asubject. The sample may be an aqueous or gaseous sample. The sample maybe a gel. The sample may include one or more fluid component. In someinstances, solid or semi-solid samples may be provided. The sample mayinclude tissue collected from the subject. The sample may include abodily fluid, secretion, and/or tissue of a subject. The sample may be abiological sample. The biological sample may be a clinical sample. Thebiological sample may be a bodily fluid, a secretion, and/or a tissuesample. Examples of biological samples may include but are not limitedto, whole blood, blood serum, blood plasma, saliva, urine, gastricfluid, digestive fluid, tears, stool, semen, vaginal fluid, interstitialfluid, fluid derived from tumorous tissue, ocular fluids, sweat, mucus,earwax, oil, glandular secretions, breath, spinal fluid, hair,fingernails, skin cells, throat swab, nasal swab, nasopharyngeal wash,spinal fluid, cerebral spinal fluid, tissue, biopsy, placental fluid,amniotic fluid, cord blood, lymphatic fluid, fluid from a body cavity,sputum, pus, microbiota, meconium, breast milk, and other secretions andexcretions.

A sample may be provided by a human or animal. A sample may be providedby a vertebrate animal; such a vertebrate animal may be a mammal. Asample may be provided by a mammal selected from the groups of mammalsconsisting of murine, ovine, bovine, equine, canine, simian, human, andother mammals. A sample may be provided by a farm animal, a sportanimal, or a pet. The sample may be collected from a living or deadsubject.

As used herein, a sample may be but is not limited to a blood sample, ora portion of a blood sample, may be of any suitable size or volume, andis preferably of small size or volume. In some embodiments of the assaysand methods disclosed herein, measurements may be made using a smallvolume blood sample, or no more than a small volume portion of a bloodsample, where a small volume may be defined as defined above. A bloodsample may be diluted prior to analysis; a portion of a blood sample maybe diluted prior to analysis; a portion of a blood sample may be analiquot of untreated (e.g., whole blood), or may be an aliquot of bloodplasma, or may be an aliquot of blood serum, or may be an aliquot ofanother portion or component of blood.

A sample may be a small-volume sample, or no more than a small-volumeportion of a sample, where a small volume comprises a volume as definedabove. A sample, or a portion thereof, may be diluted after collection.A sample, or a portion thereof, may be diluted prior to analysis. Asample, or a portion thereof, may be diluted prior to detection,quantification, characterization, or measurement of an analyte in thesample, or a portion thereof.

One or more collection mechanisms may be used in the collection of asample from a subject. A collection mechanism may use one or moreprinciple in collecting the sample. For example, a sample collectionmechanism may use gravity, capillary action, surface tension,aspiration, vacuum force, pressure differential, density differential,thermal differential, or any other mechanism in collecting the sample,or a combination thereof. A bodily fluid may be drawn from a subject andprovided to a device in a variety of ways, including but not limited to,finger-stick, lancing, injection, pumping, swabbing, pipetting,breathing, and/or any other technique described elsewhere herein. Thebodily fluid may be provided using a bodily fluid collector. A bodilyfluid collector may include a lancet, capillary, tube, pipette, syringe,needle, microneedle, pump, porous membrane or any other collector.

In one embodiment, a lancet punctures the skin of a subject and draws asample using, for example, gravity, capillary action, aspiration,pressure differential and/or vacuum force. In some embodiments, a patchmay comprise a plurality of microneedles, which may puncture the skin ofa subject. Where needed, the lancet, the patch, or any other bodilyfluid collector may be activated by a variety of mechanical, electrical,electromechanical, or any other known activation mechanism or anycombination of such methods.

In one example, a subject's finger (or other portion of the subject'sbody) may be punctured to yield a bodily fluid. The bodily fluid may becollected using a capillary tube, pipette, swab, drop, or any othermechanism known in the art. In another embodiment where no activemechanism (beyond the body) is required, a subject can simply provide abodily fluid to the device, as for example, could occur with a salivasample or a finger-stick sample.

A bodily fluid may be drawn from a subject and provided to a device in avariety of ways, including but not limited to, finger-stick, lancing,injection, and/or pipetting. The bodily fluid may be collected usingvenous or non-venous methods. The bodily fluid may be provided using abodily fluid collector. A bodily fluid collector may include a lancet,capillary, tube, pipette, syringe, venous draw, or any other collectordescribed elsewhere herein. In one embodiment, a lancet punctures theskin and draws a sample using, for example, gravity, capillary action,aspiration, or vacuum force. The lancet may be part of the readerdevice, part of the cartridge, part of a system, or a stand-alonecomponent, which can be disposable. Where needed, the lancet may beactivated by a variety of mechanical, electrical, electromechanical, orany other known activation mechanism or any combination of such methods.In one example, a subject's finger (or other portion of the subject'sbody) may be punctured to yield a bodily fluid. Examples of otherportions of the subject's body may include, but is not limited to, thesubject's hand, wrist, aim, torso, leg, foot, ear, or neck. The bodilyfluid may be collected using a capillary tube, pipette, or any othermechanism known in the art. The capillary tube or pipette may beseparate from the device and/or cartridge, or may be a part of a deviceand/or cartridge or vessel. In another embodiment where no activemechanism is required, a subject can simply provide a bodily fluid tothe device or system, as for example, can occur with a saliva sample.The collected fluid can be placed within the device or system. A bodilyfluid collector may be attached to the device or system, removablyattachable to the device or system, or may be provided separately fromthe device or system.

As used herein, a “finger-stick” refers to: i) the act of making a smallpuncture in the skin of a subject, allowing a small amount (e.g., adroplet, or one, two, or a few drops) of blood to flow and becomeavailable for collection; ii) the puncture itself; and iii) the bloodcollected thereby. Blood may be liberated in a finger-stick, forexample, by use of a lancet or other sharp implement effective to piercethe skin of a subject. Typically, only a small amount of blood iscollected in this way.

When referring to a volume, e.g., a “finger-stick volume” or “the volumeof a finger-stick”, the term “finger-stick” refers to the volume of afew droplets of blood typically obtained from a finger-stick. A singledroplet of blood may have a volume of about 20-50 μL, e.g., about 40 μL.Thus, a few droplets of blood obtained from a finger-stick may provide avolume of about 50 μL to about 250 μL, or about 75 μL to about 200 μL,or, in some instances, between about 100-150 μL. Advantages of obtainingblood from a finger-stick include minimal discomfort to the subject andease of access, as compared to obtaining blood from a vein or artery.Typically, only a small amount of blood is collected in this way (e.g.,the amount of blood collected from a finger-stick may be about 250 μL orless, or about 200 μL or less, or about 150 μL or less, or about 100 μLor less, or about 50 μL or less, or about 25 μL or less, or about 15 μLor less, or about 10 μL or less, or about 5 μL or less, or about 3 μL orless, or about 2 μL or less, or about 1 μL or less). Blood from afinger-stick may be collected, e.g., by needle, syringe, capillary tube,or other method. Blood from a finger-stick may be collected fortransport to another location; for storage prior to use or analysis; forimmediate use; or for a combination of the same.

In some embodiments of the assays and methods disclosed herein,measurements may be made using a small-volume sample, where a smallvolume comprises about 500 μL or less, or about 400 μL or less, or about300 μL or less, or about 250 μL or less, or about 200 μL or less, orabout 150 μL or less, or about 100 μL or less, or about 75 μL or less,or about 50 μL or less, or about 25 μL or less, or about 20 μL or less,or about 15 μL or less, or about 10 μL or less, or about 8 μL or less,or about 6 μL or less, or about 5 μL or less, or about 4 μL or less, orabout 3 μL or less, or about 2 μL or less, or about 1 μL or less, orabout 0.5 μL or less, or about 0.4 μL or less, or about 0.3 μL or less,or about 0.2 μL or less, or about 0.1 μL or less. In embodiments, asmall-volume sample comprises a small volume of no more than about 0.05μL; or comprises no more than about 0.01 μL.

Assay methods disclosed herein may be performed on automatic sampleanalysis devices and systems, including commercially available automaticsample analysis devices and systems. Commercially available automaticsample analysis devices and systems may be obtained, for example, fromAbbott (Abbott Diagnostics, Lake Forest, Ill., USA), Roche (RocheDiagnostics, Basel, CH), Siemens (Siemens Healthcare Diagnostics,Malvern, Pa., USA), Beckman Coulter (Beckman Coulter, Inc., Brea,Calif., USA), Ortho Clinical Diagnostics (Ortho Clinical Diagnostics,Rochester, N.Y., USA), and other manufacturers. Some analysis devicesand systems are described in the scientific literature, in some patents,and some analyzers are commercially available. Current commercialanalyzers include, for example, the DiaSorin Analyzers (DiaSorin S. p.A., Saluggia, Italy); the ADVIA Chemical Systems (Siemens HealthcareDiagnostics, Malvern, Pa., USA); the BD Max™ (Becton Dickinson, FranklinLakes, N.J., USA); the ThunderBolt® from Gold Standard Diagnostics(Davis, Calif., USA); Cobas® Analyzers (Roche Diagnostics, Basel, CH);Ventana Symphony systems (Ventana Medical Systems, a division of Roche);the Bloodhound™ system of analyzers (Constitution Medical Investors,Inc., now a subsidiary of Roche); the CELL-DYN Ruby system (AbbottDiagnostics, Lake Forest, Ill., USA); and others.

An automatic sample analysis device or system may be configured toreceive the sample, whether it be directly from a subject, from a bodilyfluid collector, or from any other mechanism. A sample may be placedwithin an automatic sample analysis device or system. A samplecollection unit of the device may be configured to receive the sample.In some embodiments, a sample may be provided directly to an automaticsample analysis device or system, or a vessel or component may be usedas a conduit or means for providing a sample to an automatic sampleanalysis device or system.

In embodiments, devices and systems may be modified for use withsmall-volume samples. For example, clinical analysis devices and systemshaving sample vessels designed for samples having volumes most readilymeasured in milliliters (mL) (e.g., requiring minimum volumes of about 1mL or more) may be modified for use with small-volume samples (e.g.,samples having volumes most readily measured in microliters (μL)) byplacing inserts into the sample vessels, effective that the volumeavailable for the sample is reduced while the outer dimensions of thesample vessels remain unchanged, and so remain compatible with theclinical analysis devices or systems. Thus, in such embodiments, amodified sample container may be used in a clinical analysis device,where the modification comprises placing an insert into the samplecontainer effective to reduce the space available for the sample. Inembodiments, methods for modifying the analysis of samples in a clinicalanalysis device include reducing the sample volume that is analyzed bythe clinical analysis device by placing an insert into the samplecontainer. In embodiments, methods for modifying the analysis of samplesin a clinical analysis device include reducing the sample volume that isanalyzed by the clinical analysis device by providing a substitute orreplacement sample container having a smaller volume than the originalsample container.

In embodiments, methods for reducing the volume of sample used during,or required for, sample analysis include providing an insert which fitsin a sample container effective to reduce the volume of sample held bythe combined sample container and insert; or providing a substitute orreplacement sample container which has a smaller volume than theoriginal sample container. The sample may be contained within a samplecontainer during at least a portion of the performance of said originalassay, said sample container comprising an internal cavity for holdingsaid sample, said internal cavity having a volume, and wherein any ofthe foregoing methods comprise reducing said volume of said internalcavity. In embodiments, reducing the volume of said internal cavitycomprises providing an alternative sample container.

In embodiments, reducing the volume of said internal cavity comprisesplacing an insert into said internal cavity. In embodiments, an insertmay comprise an insert cavity configured to hold said sample, whereinsaid insert cavity comprises a volume less than said internal cavityvolume. The sample held in an insert may be a diluted sample, or may bean undiluted sample. Thus, in embodiments, an insert is effective toinsure that the residual amount of sample remaining in a samplecontainer (after draining the container) comprises only a small volumeof sample. In embodiments, an insert may be configured effective toreduce the amount of residual sample volume remaining in the insert in asample container after draining the insert in the sample container, ascompared to the amount of residual sample volume that would remain afterdraining sample from the sample container in the absence of the insert.In embodiments, an insert may be configured effective that opticalsignals indicative of the presence of, or quantification of, a targetsubstance in a sample contained within said insert may be detected bysaid optical detector.

As disclosed herein, a sample or sample aliquot may be diluted; a firstsample aliquot (or sample) may be diluted by a first dilution factorthat is different than the dilution factor by which a second samplealiquot is diluted, and a first sample may be diluted by a differentamount than a second sample aliquot (or sample). In embodiments, a firstsample aliquot (or sample) may be diluted and a second sample aliquot(or sample) may not be diluted.

In embodiments, a sample may be diluted by operation of an automaticsample analysis device or system, and then a target analyte in thesample is reacted or labeled, and the presence or absence of the targetanalyte is detected, or the amount or level of target analyte in thesample is measured. Following such detection and/or measurement, asignal or other indication regarding the presence or absence, or level,or both, of the target analyte in the sample is provided.

In embodiments, a reagent may be, or may be used as, a diluent, and, inembodiments, may be used to dilute a sample. In embodiments, a diluentand a sample may be mixed within an automatic sample analysis device orsystem. In embodiments, a diluent and a sample may be mixed within anautomatic sample analysis device or system, and the diluted sample mayfurther be mixed with a reagent. In embodiments, a diluent, a sample,and a reagent may be mixed within an automatic sample analysis device orsystem.

In embodiments, a calibration reagent may be diluted within an automaticsample analysis device or system, or within the housing thereof. Inembodiments, a plurality of calibrators may be diluted within anautomatic sample analysis device or system, or within the housingthereof. In embodiments, a sample provided on a cartridge may be dilutedwithin an automatic sample analysis device or system, or within thehousing thereof, and one or more calibration reagents may be dilutedwithin the automatic sample analysis device or system, or within thehousing thereof.

In embodiments, a sample may be diluted prior to delivery of thecartridge to an automatic sample analysis device or system, and one ormore calibration reagents (i.e., one or more calibrators) may be dilutedprior to delivery of the sample or of the calibrator to an automaticsample analysis device or system.

In embodiments, a sample or sample aliquot may be diluted; a firstsample aliquot (or sample) may be diluted by a first dilution factorthat is different than the dilution factor by which a second samplealiquot is diluted, and a first sample may be diluted by a differentamount than a second sample aliquot (or sample). In embodiments, a firstsample aliquot (or sample) may be diluted and a second sample aliquot(or sample) may not be diluted.

Sample Analysis

In one non-limiting example, some goals of sample analysis includedetecting the presence or absence of a target analyte in a sample, anddetermining the amount of a target analyte in a sample. Assays fordetecting the presence or absence of a target analyte in a sample, andassays for determining the amount of a target analyte in a sample areexamples of methods of sample analysis. Performance of sample analysisincludes processing a sample, and includes analyzing a sample. Thus,sample analysis includes processing steps and includes analyzing steps.It will be understood that sample analysis may be performed on a portionof a sample as well as on an entire sample. It will be understood thatsample analysis may be performed on a diluted sample, or portionthereof, as well as on an undiluted sample, or portion thereof.

Methods, devices and systems for sample analysis may be used to performassays on a sample, or samples, in order to detect, determine, orquantify some characteristic of a sample (such as detecting whether ornot the sample contains a particular analyte, or such as determining theconcentration of a particular analyte present in the sample). In anassay, a sample may be prepared for use, and may be used, in the assayin ways determined by the nature of the target analyte and by the natureand amount of sample available for use in the assay. Steps useful inpreparing a sample for use in an assay may be termed “processing” steps,while steps which make, or are closely linked to making, measurementsregarding the presence, or amount, or concentration of a target analytemay be termed “analyzing” steps.

Thus, sample analysis includes both processing step(s) and analyzingstep(s).

Sample analysis includes processing of a sample, or portion thereof,whether diluted on undiluted. Processing may include, for non-limitingexample, providing, storing, transporting, warming, cooling, freezing,filtering, coagulating, separating, centrifuging, diluting, preserving,and other steps.

Sample analysis also includes analyzing a sample, or portion thereof,whether diluted on undiluted. Analyzing may include, for non-limitingexample, reacting, hybridizing, binding, illuminating, detecting,comparing (e.g., to a standard curve), subtracting (e.g., valuesobtained from a blank), and other steps.

Some steps, such as mixing, sonicating, labeling, incubating, chelating,and other steps, may be considered processing steps, or may beconsidered analyzing steps, or both.

Typical assays of biological materials may require many milliliters ofsample. In many cases where different assays are to be run, e.g., formultiple analytes, or for different analyte types, multiple samples maybe obtained. Such volumes of sample, and such multiple acquisitions ofsample from a subject, may be difficult, uncomfortable, andtime-consuming.

However, reducing the volume of sample that is required for sampleanalysis provides advantages in comfort, accessibility, and cost; andmay provide advantages in speed, simplicity and ease of analysis.Increasing the speed of an assay provides quicker results, which willtypically be appreciated by the subject from whom the sample is taken.

Current commercial analyzers typically add sample to a vessel (such as acuvette) for placement in an analysis device or system. Reagents may beadded to the sample, including, for example, reagents containingmolecules which specifically bind to or react with a target substance,or analyte, in the sample. Further reagents may be added which label, orallow visualization or detection of, the target substance. The presenceof the substance, or the amount of the substance, in the sample may bedetected or measured. The detection or measurement may be compared to acalibration curve. Finally, the results of these actions may be printedout or otherwise communicated to a user.

As disclosed herein, it is advantageous to reduce the volume of samplerequired for testing. For example, it is advantageous to reduce thevolume of sample used in, or required for, processing steps; and it isadvantageous to reduce the volume of sample used in, or required for,analyzing steps. However, simply providing smaller amounts of sample toa machine, or using smaller amounts of sample in an assay, withoutfurther modifications, is typically fruitless, since the volumes ofreagents; the concentrations of reagents and of constituents ofreagents; the fluid-handling apparatus (where the sample is liquid); thetransport means (for solid or fluid samples); the illumination means (ifany); the signal detection apparatus; and other means, mechanisms,devices, systems, and system particulars may be incorrect, mis-matched,or incompatible with the reduced volume samples.

It is also advantageous to reduce the time required to perform a test.However, reducing the volume of a sample taken from a subject willreduce the amount of target substance in the sample, and will typicallyreduce the signal produced by assays for the detection or quantificationof the substance, all of which may lead to an increase in the timerequire to perform a test.

Methods for Diluting a Sample and for Using a Diluted Sample

An automatic sample analysis device or system may be configured toaccept a sample, or aliquot of a sample, and to analyze the sample forthe presence or absence of an analyte, or of a plurality of analytes. Inembodiments, an automatic sample analysis device or system may analyze asample, or a calibration reagent, or both. A sample, or aliquot thereof,may be diluted when provided to an automatic sample analysis device orsystem. A sample, or aliquot thereof, may be provided undiluted to anautomatic sample analysis device or system. A sample, or aliquotthereof, may be diluted by an automatic sample analysis device orsystem. A calibration reagent may be provided undiluted to an automaticsample analysis device or system, or may be diluted when provided to anautomatic sample analysis device or system. A calibration reagent may bediluted by an automatic sample analysis device or system.

Dilution of a small-volume sample, or a small-volume aliquot of asample, increases the volume of the material subsequently available foranalysis following dilution, although dilution also decreases theconcentration of analytes in the resulting diluted solution. Theresulting greater volume following dilution may make transport,manipulation, mixing, aliquotting, further dilution, or other actionperformed with or on the resulting diluted sample easier to perform thanwould be the case in the absence of such dilution. Accordingly, dilutionof a sample, or a small-volume aliquot of a sample, may provideadvantages for the analysis of the sample or sample aliquot.

In embodiments, the presence or absence of a target analyte in thediluted sample is detected within an automatic sample analysis device orsystem. In embodiments, the presence or absence of two target analytesin one or more portions of a diluted sample are detected within anautomatic sample analysis device or system. In embodiments, the amountof a target analyte in the diluted sample is measured within anautomatic sample analysis device or system. In embodiments, the amountsof two target analytes in one or more portions of a diluted sample aremeasured within an automatic sample analysis device or system. Inembodiments, the presence or absence, or the amount, of a first targetanalyte in a sample or portion of a sample, is detected or measuredwithin an automatic sample analysis device or system, and the presenceor absence, or the amount, of a second target analyte in a sample orportion of a sample, is detected or measured within the same automaticsample analysis device or system. In embodiments, the presence orabsence, or amounts, of two or more target analytes in one or moreportions of a sample, one or more of which may be diluted samples ordiluted sample portions, are detected within one automatic sampleanalysis device or system.

In embodiments, the presence or absence, or amount, of a target analytein a sample, or portion of a sample, is detected or measured by opticalmeans within an automatic sample analysis device or system. Inembodiments, the presence or absence, or amount, of a target analyte ina diluted sample, or a diluted sample portion, is detected or measuredby optical means within an automatic sample analysis device or system.In embodiments, the presence or absence, or the amounts, of two or moretarget analytes in a sample, sample portion, diluted sample, or adiluted sample portion, are detected or measured by optical means withinan automatic sample analysis device or system. In embodiments, opticaldetection means may include spectrophotometers, photomultiplier tubes,charge-coupled devices, photodiodes, avalanche photodiodes, avalanchephotodiode arrays, pin diodes, digital cameras, and other opticaldevices and optical detection means.

Applicant provides herein methods for reducing the volume of samplerequired for assays for detecting the presence of a target substance ina sample. Applicant provides herein methods for reducing the timerequired for the performance of assays for detecting the presence of atarget substance in a sample. Applicant provides herein methods forreducing the volume of sample required, and for reducing the timerequired, for the performance of assays for detecting the presence of atarget substance in a sample.

Applicant provides herein methods for reducing the volume of sample usedfor, or required for, processing steps in sample analysis. Applicantprovides herein methods for reducing the volume of sample used for, orrequired for, analyzing steps in sample analysis. Applicant providesherein methods for reducing the volume of sample used for, or requiredfor, both processing steps and analyzing steps in sample analysis.

Applicant provides herein methods for reducing the volume of samplerequired for assays for quantifying the amount of a target substance ina sample. Applicant provides herein methods for reducing the timerequired for the performance of assays for quantifying the amount of atarget substance in a sample. Applicant provides herein methods forreducing the volume of sample required and for reducing the timerequired for the performance of assays for quantifying the amount of atarget substance in a sample.

In embodiments, the methods comprise a step of diluting a sample. Suchdilution steps are typically performed prior to other assay steps. Inembodiments, the methods comprise a step of diluting a sample and ofdiluting a calibrator (e.g., a reagent containing a known amount ofanalyte that is used as a reference standard). For example, methods maycomprise a step of diluting a sample by a dilution factor and ofdiluting a calibrator by the same dilution factor. Methods may furthercomprise a step of diluting a sample by a dilution factor and ofdiluting a calibrator by the same dilution factor. Such dilution stepsare typically performed prior to other assay steps. In embodiments,reagents used in such assays are prepared in conformance with thedilution factor, e.g., the reagent concentrations and reaction times ofthe assay are configured for use with samples (and calibrators) thathave been diluted by the dilution factor.

In embodiments, the methods comprise a step of diluting a sample, e.g.,diluting a sample prior to mixing the sample with a reagent, prior todetecting an analyte in the sample, or prior to other treatment steps.In embodiments, such a further step of diluting a sample is performedprior to all steps of standard protocols, or of manufacturer protocols,for the analysis of the sample. In embodiments, such a further step ofdiluting a sample is performed prior to a pre-treatment step, and priorto treatment steps in the analysis of the sample. In embodiments, such afurther step of diluting a sample is performed following a pre-treatmentstep, and prior to treatment steps in the analysis of the sample. Inembodiments, such a further step of diluting a sample is performed priorto all other steps in the analysis of the sample.

Dilution of a sample, or aliquot thereof, by a factor of “X” means thatthe resulting total volume, following addition of diluent to a sample(or aliquot thereof), is “X” times the volume of the original samplevolume (or aliquot volume). Dilution of a sample, or aliquot thereof, bya factor of X results in a dilution ratio of X:1. Accordingly, dilutionof a sample, or aliquot thereof, by a factor of 2 means that theresulting total volume, following addition of diluent to a sample (oraliquot thereof), is twice the volume of the original sample volume (oraliquot volume). Dilution of a sample, or aliquot thereof, by a factorof 2 results in a dilution ratio of 2:1. Accordingly, dilution of asample, or aliquot thereof, by a factor of 3 results in a dilution ratioof 3:1; dilution by a factor of 4 results in a dilution ratio of 4:1;dilution by a factor of 10 results in a dilution ratio of 10:1; andsimilarly for other dilution factors.

In embodiments, methods for detecting the presence or absence of, or formeasuring a level of, an analyte in a diluted sample, where the samplehas been diluted by a dilution factor, include further steps comprisingmeasuring the amount of analyte in a calibration solution that has beenprepared to have an amount of analyte that is proportional to the amountof analyte contained in a calibration solution that has been diluted bythe same dilution factor as the sample (i.e., the sample and thecalibration solution are equivalently diluted).

In embodiments, a sample may be diluted by a factor of 2, 3, 4, 5, 6, 7,8, 9, 10, 12, 14, 15, 16, 18, 20, 25, 30, 35, 40, 50, 100, or more. Inembodiments, a sample may be diluted by a factor of 2, 3, 4, 5, 6, 7, 8,9, 10, 12, 14, 15, 16, 18, 20, 25, 30, 35, 40, 50, 75, 100, 150, 200,250, 500, 1000, or more after a pre-treatment step, and prior to othersteps in the analysis of a sample. In embodiments, a sample may bediluted by a factor of 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 15, 16, 18,20, 25, 30, 35, 40, 50, 75, 100, 150, 200, 250, 500, 1000, or more priorto all other steps in the analysis of a sample. In embodiments, a samplemay be diluted by a factor of 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 15,16, 18, 20, 25, 30, 35, 40, 50, 75, 100, 150, 200, 250, 500, 1000, ormore during the analysis of a sample, wherein the analysis is directedat detecting the presence or amount of at least two target analytes inthe sample; in further embodiments, the analysis of the sample isdirected at detecting the presence or amount of at least three targetanalytes in the sample. In embodiments, more than one aliquot of thesample, or more than one aliquot of the diluted sample, is used indetecting the presence or amount of an analyte, or of a plurality ofanalytes.

In embodiments, methods comprising a step of diluting a sample alsoinclude a step of analyzing a calibrator; in embodiments, the calibratoris diluted, e.g., by the same dilution factor as the sample. Inembodiments, a step of diluting a sample and a step of diluting acalibrator are performed at substantially the same time. In embodiments,a calibrator may be diluted by a factor of 2, 3, 4, 5, 6, 7, 8, 9, 10,12, 14, 15, 16, 18, 20, 25, 30, 35, 40, 50, 75, 100, 150, 200, 250, 500,1000, or more.

A portion of a sample, such as a portion of a small sample, may be adiluted portion. For example, a portion of a sample may be divided froman original undivided sample, and then that portion may be diluted(e.g., by mixing with a diluent, or by placement of the sample portioninto a diluent). In embodiments, a diluted portion of a sample may beprovided by diluting an original undivided sample (e.g., by mixing witha diluent to the original undivided sample, or by placement of theoriginal undivided sample into a diluent), and then taking a portion ofthe diluted sample to provide a diluted sample portion. In embodiments,a diluted portion of a sample may be provided by taking a portion of adiluted sample or a diluted sample portion, and further diluting thatportion.

Applicant discloses methods for detecting the presence or absence, ormeasuring a level, of an analyte in a sample using an automatic sampleanalysis device or system in the performance of an assay protocol, themethod comprising:

Diluting said sample by mixing with a diluent;

Reacting or labeling a target analyte in said diluted sample after saiddilution step, wherein said reacting or labeling is performed within anautomatic sample analysis device or system;

Detecting said reaction or said label in said diluted sample after saidreacting or labeling step, wherein said detecting is performed within anautomatic sample analysis device or system;

Transmitting a signal communicating the results of said assay protocol;

Whereby the presence or absence of, or level of, the analyte is detectedor measured in said sample by use of said automatic sample analysisdevice or system in the performance of said assay protocol. Inembodiments, the automatic sample analysis device or system is locatedat, or near the premises of a retail location, such as, e.g., a market,a retail pharmacy, a hospital, medical clinic, dialysis center, doctor'soffice, dentist's office, or other medically related location.

In embodiments, the method comprises detection of the analyte in asample according to an assay protocol that differs from themanufacturer's suggested assay protocols, or other standard protocols,by inclusion of a dilution step. In embodiments, the sample is dilutedprior to the performance of an assay comprising the steps of amanufacturer's suggested assay protocol, or other standard protocols,for the automatic sample analysis device or system.

Further embodiments of methods for detecting the presence or absence, ormeasuring a level, of an analyte in a sample using an automatic sampleanalysis device or system comprise:

Diluting said sample by mixing with a diluent;

Mixing a first reagent with said diluted sample at a first mixing time;

Mixing a second reagent with said mixture comprising diluted sample andsaid first reagent at a second mixing time;

Detecting the presence or absence, or measuring a level, of said analyteat a first detection time using said detector; and

Transmitting a signal communicating the results of said assay protocol;

Whereby the presence or absence of, or level of, the analyte is detectedor measured in said sample. In further embodiments, Applicant disclosesa method for detecting the presence or absence, or measuring a level, ofat least two analytes in a single sample using an automatic sampleanalysis device or system comprising a detector in the performance of anassay protocol, said at least two analytes comprising a first analyteand a second analyte, the method comprising:

Diluting said sample by mixing with a diluent;

Dividing said diluted sample into at least two aliquots comprising atleast a first aliquot and a second aliquot of the diluted sample,wherein said at least two aliquots are isolated from each other and areheld within at least two containers within said automatic sampleanalysis device or system;

Mixing a first reagent with said first aliquot of the diluted sample ata first mixing time;

Mixing a second reagent with said second aliquot of the mixturecomprising diluted sample and said second reagent at a second mixingtime;

Detecting the presence or absence, or measuring a level, of said firstanalyte at a first detection time using said detector;

Detecting the presence or absence, or measuring a level, of said secondanalyte at a second detection time using the detector; and

Transmitting a signal communicating the results of said assay protocol;

Whereby the presence or absence, or levels, of at least two analytes aredetected or measured in said sample by use of said automatic sampleanalysis device or system. In embodiments, the first mixing time isdifferent than the second mixing time. In embodiments, the firstdetection time is different than the second detection time.

Further embodiments include the following methods.

A method for detecting the presence or absence, or measuring a level, ofat least two analytes in a single sample using an automatic sampleanalysis device or system comprising a detector, said at least twoanalytes comprising a first analyte and a second analyte, the methodcomprising:

Diluting said sample by mixing with a diluent;

Dividing said diluted sample into at least two aliquots comprising atleast a first aliquot and a second aliquot of the diluted sample,wherein said at least two aliquots are isolated from each other and areheld within at least two containers within said automatic sampleanalysis device or system;

Mixing a first reagent with said first aliquot of the diluted sample ata first mixing time, wherein said mixing comprises transporting saidfirst reagent or said first aliquot along one or more linear pathswithin the automatic sample analysis device or system;

Mixing a second reagent with said second aliquot of the diluted sampleat a second mixing time, wherein said mixing comprises transporting saidsecond reagent or said second aliquot along one or more linear pathswithin the automatic sample analysis device or system;

Detecting the presence or absence, or measuring a level, of said firstanalyte at a first detection time using said detector;

Detecting the presence or absence, or measuring a level, of said secondanalyte at a second detection time using the detector; and

Transmitting a signal communicating the results of said assay protocol;

Whereby the presence or absence of, or level of, of at least twoanalytes are detected or measured in a sample by use of said automaticsample analysis device or system. In embodiments, the first mixing timeis different than the second mixing time. In embodiments, the firstdetection time is different than the second detection time. Inembodiments, the presence or absence, or levels, of at least twoanalytes are detected or measured in a sample using an automatic sampleanalysis device or system within a short period of time. In embodiments,the short period of time is selected from one hour, 50 minutes, 40minutes, 30 minutes, 20 minutes, 10 minutes, and 5 minutes.

In embodiments of the methods disclosed herein, detecting the presenceor absence of, or measuring a level of, an analyte comprises comparingi) a signal produced by a detector from a detector measurement of adiluted sample with ii) a signal produced by a detector from a detectormeasurement of a diluted calibration solution, wherein the dilution ofthe calibration solution is equivalent to the dilution of the dilutedsample.

In embodiments of the methods disclosed herein, detecting the presenceor absence of, or measuring a level of, an analyte comprises comparingi) a signal produced by a detector from a detector measurement of adiluted sample with ii) a plurality of signals produced by a detectorfrom a detector measurement of a plurality of diluted calibrationsolutions, wherein the dilution of the calibration solution isequivalent to the dilution of the diluted sample, wherein prior to saiddilution, the plurality of calibration solutions contained a pluralityof known concentrations of a target calibrator; in embodiments, saidtarget calibrator comprises the analyte to be detected or measured inthe sample.

In further embodiments, methods for detecting the presence or absenceof, or for measuring a level of an analyte in a sample include i) a stepcomprising measuring a level of an analyte in a diluted sample ordiluted sample aliquot and ii) a step comprising measuring the amount ofanalyte in a calibration solution that has been diluted by the sameamount of dilution as the sample or sample aliquot. In embodiments, asample and a calibration solution are each diluted by the same amount byan automatic operation. In embodiments, a sample and a calibrationsolution are each diluted by the same amount by the same automaticoperation, or by automatic operations performed by the same device orsystem. In embodiments, a sample and a calibration solution are eachdiluted by the same amount at substantially the same time. Inembodiments, a sample and a calibration solution are each diluted by thesame amount a sample and a calibration solution are each diluted by thesame amount by the same automatic operation, or by automatic operationsperformed by the same device or system, at substantially the same time.In embodiments, a sample and a calibration solution are each diluted bythe same amount a sample and a calibration solution are each diluted bythe same amount by the same automatic operation, or by automaticoperations performed by the same device or system, by sequentialoperations including dilution of the sample and of the calibrationsolution, wherein the sample is diluted within a short period of time ofthe dilution of the calibration solution.

In embodiments, assays performed according to the methods disclosedherein comprise using an automatic sample analysis device or system in amanner that differs from the device or system manufacturer's protocolcomprise assays in which a sample is diluted prior to the performance ofassay steps of according to the device or system manufacturer'sprotocol, or other standard protocols for the device or system. Inembodiments, assays performed according to the methods disclosed hereinusing an automatic sample analysis device or system in a manner thatdiffers from the device or system manufacturer's protocol compriseassays in which a sample is diluted and a calibrator (e.g., acalibration reagent) is diluted prior to the performance of assay stepsof according to the device or system manufacturer's protocol. Inembodiments in which an assay performed according to the methodsdisclosed herein using an automatic sample analysis device or system isperformed in a manner that differs from the device or systemmanufacturer's protocol, in which a sample and a calibrator are dilutedprior to the performance of assay steps of according to the device orsystem manufacturer's protocol, the sample and the calibrator areequivalently diluted. A sample and a calibrator (e.g., a calibrationsolution containing a known concentration of an analyte) areequivalently diluted when the volume ratio of sample to diluted sampleis the same as the volume ratio of calibrator to diluted calibrator.Thus, where a calibrator and a sample are equivalently diluted, thedilution of the calibrator is equivalent to the dilution of the dilutedsample (the sample and the calibrator have been diluted by the samedilution factor).

In embodiments, each and any of the methods disclosed herein may be usedto detect at least two analytes of different analyte types that arepresent in a single sample (such detection may be performed with theundivided sample, or with an aliquot of the sample, or with two or morealiquots of the sample). In embodiments, each and any of the methodsdisclosed herein may be used to detect at least two analytes ofdifferent analyte types from a small-volume biological sample within ashort period of time (such detection may be performed with the undividedsmall-volume sample, or with an aliquot of the small-volume sample, orwith two or more aliquots of the small-volume sample). In embodiments,methods disclosed herein may be used to detect at least three, or atleast four, or at least five, or more analytes of different analytetypes, all of which may be detected from a small biological sample (suchdetection may be performed with the undivided small-volume sample, orwith an aliquot of the small-volume sample, or with two or more aliquotsof the small-volume sample), and all of which may be detected within ashort period of time. Analyte types which may be detected includenucleic acid analytes, protein analytes, lipid analytes, blood chemistryanalytes (including chemical and ion concentrations), cell-surfacemarkers, cell morphological markers, cytoplasmic markers, and otheranalyte types. Such methods may be performed by automatic sampleanalysis devices or systems according to the methods disclosed herein.

In embodiments, each and any of the methods disclosed herein may be usedto detect at least two analytes of different analyte types that arepresent in a single sample (such detection may be performed with theundivided sample, or with an aliquot of the sample, or with two or morealiquots of the sample), and to further perform a cytometry assay on thesample or portion thereof. In embodiments, each and any of the methodsdisclosed herein may be used to detect at least two analytes ofdifferent analyte types from a small-volume biological sample within ashort period of time (such detection may be performed with the undividedsmall-volume sample, or with an aliquot of the small-volume sample, orwith two or more aliquots of the small-volume sample), and to furtherperform a cytometry assay on the sample or portion thereof. Inembodiments, methods disclosed herein may be used to detect at leastthree, or at least four, or at least five, or more analytes of differentanalyte types, all of which may be detected from a small biologicalsample (such detection may be performed with the undivided small-volumesample, or with an aliquot of the small-volume sample, or with two ormore aliquots of the small-volume sample), and all of which may bedetected within a short period of time, and to further perform acytometry assay on the sample or portion thereof. Analyte types whichmay be detected include nucleic acid analytes, protein analytes, lipidanalytes, blood chemistry analytes (including chemical and ionconcentrations), cell-surface markers, cell morphological markers,cytoplasmic markers, and other analyte types. Such methods may beperformed by automatic sample analysis devices or systems according tothe methods disclosed herein.

In embodiments, each and any of the methods disclosed herein may be usedto detect an analyte, or at least two analytes, or more, present in asingle sample, where the sample is a small sample (also termed a“small-volume sample”). For example, a small sample have a volume ofabout 500 μL or less, or about 400 μL or less, or about 300 μL or less,or about 250 μL or less, or about 200 μL or less, or about 150 μL orless, or about 100 μL or less, or about 75 μL or less, or about 50 μL orless, or about 25 μL or less, or about 20 μL or less, or about 15 μL orless, or about 10 μL or less, or about 8 μL or less, or about 6 μL orless, or about 5 μL or less, or about 4 μL or less, or about 3 μL orless, or about 2 μL or less, or about 1 μL or less, or about 0.5 μL orless, or about 0.4 μL or less, or about 0.3 μL or less, or about 0.2 μLor less, or about 0.1 μL or less. A small sample may be divided intoaliquots or portions, where an aliquot or portion may have a volume ofabout 475 μL or less, or about 450 μL or less, or about 400 μL or less,or about 300 μL or less, or 250 μL or less, or about 200 μL or less, orabout 150 μL or less, or about 100 μL or less, or about 75 μL or less,or about 50 μL or less, or about 25 μL or less, or about 20 μL or less,or about 15 μL or less, or about 10 μL or less, or about 8 μL or less,or about 6 μL or less, or about 5 μL or less, or about 4 μL or less, orabout 3 μL or less, or about 2 μL or less, or about 1 μL or less, orabout 0.5 μL or less, or about 0.4 μL or less, or about 0.3 μL or less,or about 0.2 μL or less, or about 0.1 μL or less.

A portion of a sample, such as a portion of a small sample, may be adiluted portion. For example, a portion of a sample may be divided froman original undivided sample, and then that portion may be diluted(e.g., by mixing with a diluent, or by placement of the sample portioninto a diluent). In embodiments, a diluted portion of a sample may beprovided by diluting an original undivided sample (e.g., by mixing witha diluent to the original undivided sample, or by placement of theoriginal undivided sample into a diluent), and then taking a portion ofthe diluted sample to provide a diluted sample portion. In embodiments,a diluted portion of a sample may be provided by taking a portion of adiluted sample or a diluted sample portion, and further diluting thatportion.

In embodiments, the methods disclosed herein may comprise detection,identification, measurement, and analysis of analytes and samples atroom temperature, or at temperatures near 20° C. In embodiments, themethods disclosed herein may comprise detection, identification,measurement, and analysis of analytes and samples at elevatedtemperatures. In embodiments, elevated temperatures may be temperaturesabove about 25° C., above about 30° C., or above about 35° C. Inembodiments, the methods disclosed herein may comprise detection,identification, measurement, and analysis of analytes and samples attemperatures of between about 32° C. and about 40° C. In embodiments,the methods disclosed herein may comprise detection, identification,measurement, and analysis of analytes and samples at temperatures ofabout 37° C.

In embodiments, each and any of the methods disclosed herein may be usedto detect an analyte, or at least two analytes, or more, present in asingle sample, may be performed by an automatic sample analysis deviceor system, where the methods are performed according to a protocolprovided to the automatic sample analysis device or system, or areperformed according to a protocol stored within the automatic sampleanalysis device or system.

In embodiments, protocols may be updated and may be tailored to one ormore factors, where such factors may include characteristics of theautomatic sample analysis device or system, or of its environment, or ofmaterials used or incident to the analysis of a biological sample. Forexample, in embodiments, protocols may be updated and may be tailored tospecific reagents and disposables, e.g., taking into account controlreagents, calibrations of reagents, the specific properties andcharacteristics of reagents used in an assay.

In embodiments of each and any of the methods disclosed herein, a shortperiod of time may comprise less than about an hour, or less than about45 minutes, or less than about 30 minutes, or less than about 20minutes, or less than about 10 minutes, or less than about 5 minutes, orless than about 4 minutes, or less than about 3 minutes, or less. Inembodiments, a short period of time may begin when a sample is obtainedfrom a subject. In embodiments, a short period of time may begin when asample is provided to a sample analysis device or system. Inembodiments, a short period of time may begin when a sample is providedto an automatic sample analysis device or system. In embodiments, ashort period of time may begin when a sample is diluted. In embodiments,a short period of time may begin when a sample is diluted by a sampleanalysis device or system. In embodiments, a short period of time maybegin when a sample is diluted by an automatic sample analysis device orsystem. In embodiments, a short period of time may begin when a sampleis mixed with a reagent. In embodiments, a short period of time maybegin when a sample is mixed with a reagent by a sample analysis deviceor system. In embodiments, a short period of time may begin when asample is mixed with a reagent by an automatic sample analysis device orsystem.

In embodiments of each and any of the methods disclosed herein, anautomatic sample analysis device or system may analyze a sampleaccording to a protocol. In embodiments, an automatic sample analysisdevice or system may analyze a sample according to a fixed, pre-setprotocol. In embodiments, an automatic sample analysis device or systemmay analyze a sample according to a protocol that may be prepared oraltered for use with one or more of a particular type of subject, aparticular type of sample, and a particular individual subject. Inembodiments, an automatic sample analysis device or system may analyze asample according to a protocol that may be updated or altered for usewith a particular type of sample. In embodiments, an automatic sampleanalysis device or system may analyze a sample using a plurality ofdifferent reagents, wherein the different reagents of said plurality maybe updated or altered for use with one or more of a particular ofsample.

In embodiments of each and any of the methods disclosed herein, a samplemay be delivered to an automatic sample analysis device or system; inembodiments, the sample delivered to an automatic sample analysis deviceor system is a diluted sample. In embodiments in which the sample is adiluted sample, the diluted sample may be mixed with a reagent within anautomatic sample analysis device or system. In embodiments, such mixingwith a reagent is performed prior to detection of the presence orabsence of a target analyte in the diluted sample within an automaticsample analysis device or system.

In embodiments of each and any of the methods disclosed herein, thesample delivered to an automatic sample analysis device or system is anundiluted sample. In embodiments, an undiluted sample delivered to anautomatic sample analysis device or system is diluted within anautomatic sample analysis device or system. Such dilution within anautomatic sample analysis device or system may be performed prior toanalysis of the sample. In embodiments, the sample delivered to anautomatic sample analysis device or system is an undiluted sample, andthe sample is diluted and then mixed with a reagent prior to detectionof the presence or absence of a target analyte in the diluted samplewithin an automatic sample analysis device or system.

In embodiments of each and any of the methods disclosed herein,including methods for detecting the presence or absence of, or measuringa level of, an analyte in a biological sample, may be performed on ablood sample. In embodiments, the blood sample comprises a blood samplecollected by finger-stick. In embodiments, the blood sample comprises ablood sample collected by finger-stick, having a volume of less thanabout 250 μL of blood. In embodiments, the blood sample comprises ablood sample collected by finger-stick, having a volume of less thanabout 150 μL of blood. In embodiments, the blood sample comprises ablood sample collected by finger-stick, having a volume of less thanabout 100 μL of blood. In embodiments, the blood sample comprises ablood sample collected by finger-stick, having a volume of less thanabout 75 μL of blood. In embodiments, the blood sample comprises a bloodsample collected by finger-stick, having a volume of less than about 50μL of blood. In embodiments, the blood sample comprises a blood samplecollected by finger-stick, having a volume of less than about 25 μL ofblood. In embodiments, the blood sample comprises a blood samplecollected by finger-stick, having a volume of less than about 10 μL ofblood. In embodiments, the blood sample comprises a blood samplecollected by finger-stick, having a volume of less than about 5 μL ofblood. In embodiments, the blood sample comprises a blood samplecollected by finger-stick, having a volume of less than about 1 μL ofblood.

In embodiments of each and any of the methods disclosed herein,including methods for detecting the presence or absence of, or measuringa level of, an analyte in a biological sample, may be performed on aurine sample. In embodiments of each and any of the methods disclosedherein, including methods for detecting the presence or absence of, ormeasuring a level of, an analyte in a biological sample, may beperformed on a saliva sample. In embodiments of each and any of themethods disclosed herein, including methods for detecting the presenceor absence of, or measuring a level of, an analyte in a biologicalsample, may be performed on a sample selected from a throat swab, anasal swab, and a nasopharyngeal wash.

In embodiments of each and any of the methods disclosed herein,including methods for detecting the presence or absence of, or measuringa level of, an analyte, methods may comprise detecting the presence orabsence, or level of, at least two analytes in aliquots of a singlesample, or at least three analytes in aliquots of a single sample, or atleast four analytes in aliquots of a single sample.

In embodiments of each and any of the methods disclosed herein,including methods for detecting the presence or absence of, or measuringa level of, an analyte, methods may comprise detecting the presence orabsence, or level of, at least one analyte and at least one cell type inaliquots of a single sample, or at least two analytes and at least onecell type in aliquots of a single sample, or at least three analytes andat least one cell type in aliquots of a single sample, or at least fouranalytes and at least one cell type in aliquots of a single sample.

In embodiments of each and any of the methods disclosed herein,including methods for detecting the presence or absence of, or measuringa level of, an analyte using an automatic sample analysis device or anautomatic sample analysis system, such an automatic sample analysisdevice or an automatic sample analysis system may be modified for usewith small-volume samples. Such modifications may include modificationof a sample container, wherein said sample container is part of, or isused with, the automatic sample analysis device or automatic sampleanalysis system. Such modifications may include modification of aautomatic sample analysis device or an automatic sample analysis systemfor use with small-volume samples by placement of an insert into asample container, wherein said sample container is part of, or is usedwith, the automatic sample analysis device or automatic sample analysissystem. Such modifications of automatic sample analysis devices or anautomatic sample analysis systems, wherein the automatic sample analysisdevice or an automatic sample analysis system are configured for usewith an original sample container having a first internal volume forholding a sample, may include providing or using a replacement samplecontainer configured for use with small-volume samples, wherein saidreplacement sample container has a second internal volume for holding asample, wherein said second internal volume of said replacement samplecontainer is less than said first internal volume of said originalsample container. Such modifications of automatic sample analysisdevices or an automatic sample analysis systems, wherein the automaticsample analysis device or an automatic sample analysis system areconfigured for use with an original sample container having a firstinternal volume for holding a sample, may include providing or using ainsert, comprising placing an insert into the original sample containereffective to reduce the volume available to hold a sample, wherein saidinsert has a second internal volume for holding a sample, wherein saidsecond internal volume of said insert is less than said first internalvolume of said original sample container.

Further Methods for Reducing the Volume of Sample Required to Perform anAssay

Methods for reducing the volume of a sample, e.g., reducing the amountof sample required for an assay for the detection of, or quantificationof, a target substance in a sample, include methods in which a samplecontainer (such as, e.g., a cuvette, tube, caplet, or other container)is altered for use with smaller volumes of sample; such alterationsinclude alterations in the volume of an internal chamber of a samplecontainer (e.g., reduction in such volume), alterations in the shape ofan internal chamber of a sample container (e.g., alterations making thechamber longer and narrower), alterations in a wall of an internalchamber of a sample container (e.g., providing a reflective, e.g.,mirrored, or refractive (e.g., focusing) surface, and other alterations.

Methods for reducing the volume of a sample, e.g., reducing the amountof sample required for an assay for the detection of, or quantificationof, a target substance in a sample, include methods in which an insertis provided and placed within a sample container (such as, e.g., acuvette, tube, caplet, or other container), reducing the internal volumeavailable to hold a sample. Such an insert may be configured to fitsnugly within a cavity of a sample container, and to have a cavity forholding a sample, where the cavity of the insert has a smaller volumethan the cavity of the sample container. Thus, methods for reducing thevolume of a sample used for, or required for, processing steps in sampleanalysis include steps of placing such in insert within a samplecontainer. In addition, methods for reducing the volume of a sample usedfor, or required for, analyzing steps in sample analysis include stepsof placing such in insert within a sample container. Furthermore,methods for reducing the volume of a sample used for, or required for,processing steps and analyzing steps in sample analysis include steps ofplacing such in insert within a sample container.

Devices useful for reducing the volume of a sample, e.g., reducing theamount of sample required for an assay for the detection of, orquantification of, a target substance in a sample, include insertsconfigured for placement within a sample container having a samplecontainer cavity (such as, e.g., a cuvette, tube, caplet, or othercontainer), the insert having an internal cavity whose volume is lessthan the volume of the sample container cavity. Thus, such inserts areuseful in reducing the volume of sample used for, or required for,processing steps in sample analysis; are useful in reducing the volumeof sample used for, or required for, analyzing steps in sample analysis;and are useful in reducing the volume of sample used for, or requiredfor, both processing steps and analyzing steps in sample analysis.

Methods for reducing the volume of a sample, e.g., reducing the amountof sample required for an assay for the detection of, or quantificationof, a target substance in a sample, include methods in which a detector,such as a light detector, or an electronic detector, or other detector,is altered for use with smaller volumes of sample. Methods for reducingthe volume of a sample, e.g., reducing the amount of sample required foran assay for the detection of, or quantification of, a target substancein a sample, include methods in which a sample container is altered foruse with smaller volumes of sample, so that, for example, a long narrowchamber provides a suitable pathlength for optical detection whilerequiring a smaller sample volume than an original container. Methodsfor reducing the volume of a sample, e.g., reducing the amount of samplerequired for an assay for the detection of, or quantification of, atarget substance in a sample, include methods in which a source ofillumination required for optical detection or measurement is alteredfor use with smaller volumes of sample; typically, such alterationincludes increasing illumination intensity, but may also, or instead,include altering the wavelength of light, or the polarization of light,provided by the source of illumination. Methods for reducing the volumeof a sample, e.g., reducing the amount of sample required for an assayfor the detection of, or quantification of, a target substance in asample, include methods in which a sample is placed nearer to adetector, such as a light detector, or an electronic detector, or otherdetector, so that a smaller signal from a smaller sample volumes remainsdetectable. Thus, alterations suitable for use with smaller samplevolumes include increasing the sensitivity of the light detector, orelectronic detector; increasing the intensity of illumination used inanalysis of smaller volumes of samples; increasing the path lengththrough which light passes prior to detection by a detector; decreasingthe distance between the sample and a detector; altering the wavelengthof light, or detecting multiple wavelengths of light, passing thoroughor absorbed by a smaller volume of sample; and other alterations.

Methods for reducing the volume of a sample used during sample analysis,e.g., reducing the amount of sample required for an assay for thedetection of, or quantification of, a target substance in a sample,include methods in which a small sample is diluted with a diluent, suchas water, or buffer, or other diluent. In this way, the volume of thematerial presented for analysis and detection may remain the same, ormay be similar, to the volume that was initially used or required. Sincea diluted sample may provide a smaller signal than an undiluted sample,similar modifications in light intensity, illumination wavelength,container configuration, container volume, sample placement, and othermodifications may be used with a diluted sample.

Methods for reducing the volume of a sample used during sample analysis,e.g., reducing the amount of sample required for an assay for thedetection of, or quantification of, a target substance in a sample,include methods in which a larger amount (absolute amount) of dye, orenzyme substrate, or other molecule used in producing a signalindicative of the presence, or amount, of a target molecule, is added toa small sample; or methods in which a larger concentration of dye, orenzyme substrate, or other molecule used in producing a signalindicative of the presence, or amount, of a target molecule, is added toa small sample; or a dye, enzyme substrate, or other molecule used inproducing a signal indicative of the presence, or amount, of a targetmolecule, providing a more intense or stronger signal is added to asmall sample, as compared to the original dye amount, concentration, ormake-up.

Methods for reducing the volume of a sample, e.g., reducing the amountof sample required for an assay for the detection of, or quantificationof, a target substance in a sample, include methods in which the opticalproperties of a sample container are altered so as to focus, or reflect,light impinging on the sample to provide increased light intensity tothe sample (e.g., increased light intensity to a smaller volume, wherethe sample is a smaller volume sample) as compared to the opticalproperties and volumes of the original configuration. Thus, a samplecontainer may be altered to include lenses, or lensing surfaces, whichrefract light onto a sample chamber, or onto a portion of a samplechamber, in which a sample is held. Thus, a sample container may bealtered to include mirrors, or mirrored surfaces, which reflect lightonto a sample chamber, or onto a portion of a sample chamber, in which asample is held.

Accordingly, methods for reducing the amount of sample required for anassay for the detection of, or quantification of, a target substance ina sample, include the following methods.

Applicants disclose methods for reducing the volume of sample used inthe performance of an assay for the detection of, or quantification of,a target substance in a sample, where the assay comprises opticaldetection of a target substance in a sample. Such methods may comprise,for example, reducing the volume of sample used in the assay from afirst (larger) volume to a second (smaller) volume, where the assay waspreviously performed using a first volume of sample; and increasing theintensity of illumination applied to the sample. Such increasedillumination is used to detect or quantify a target substance in thesample. Such a method may allow detection, quantification, or detectionand quantification of the target substance in a reduced volume ofsample, since many optical signals are enhanced at higher levels ofillumination intensity. Such detection, quantification, or detection andquantification may include absorbance measurements, transmissionmeasurements, turbidity measurements, polarization measurements,circular dichroism measurements, light scattering measurements, andother optical measurements. It will be understood that these, and otheroptical measurements, may be used for any of the methods, such as, e.g.,any optical methods, disclosed herein.

Further methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, include methods where the assay comprisesdetection of a fluorescent label. Such methods may comprise, forexample, reducing the volume of sample used in the assay from a firstvolume to a second volume, wherein said second volume is less than saidfirst volume, wherein the assay was previously performed using a firstvolume of sample; and increasing the intensity of light illuminating thesample and assay reagents during fluorescence measurements. Such methodsmay allow detection, quantification, or detection and quantification ofthe target substance in a reduced volume of sample, since fluorescencefrom many labels is enhanced at higher levels of illumination.

Thus, as disclosed herein, an increase in light intensity may beutilized in methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample. Light intensity may be increased from alight source by any suitable means. Providing an additional lightsource, or a plurality of additional light sources, is effective toincrease the intensity of illumination applied to a sample. Increasingthe power (e.g., by increasing the current, or by increasing thevoltage, or both) applied to a light source is effective to increase theintensity of illumination applied to a sample. Providing a differentlight source, capable of providing increased light intensity, iseffective to increase the intensity of illumination applied to a sample;for example, an original light source of a first type may be replacedby, e.g., an incandescent light source, a halogen light source, a laserlight source, a diode light source, a sodium vapor light source, orother light source. Lenses, mirrors, prisms, fiber optics, and otheroptical elements may be provided effective to increase the intensity ofillumination applied to a sample.

Further methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, comprise assays comprising detection of adye. Such methods, for example, may comprise reducing the volume ofsample used in the assay from a first volume to a second volume, whereinsaid second volume is less than said first volume, wherein the assay waspreviously performed using a first volume of sample; and increasing theconcentration of a dye added to the sample, where the dye labels atarget substance in said sample. Such methods may allow detection,quantification, or detection and quantification of the target substancein a reduced volume of sample, since signals from many dyes or otherlabels are enhanced at higher concentrations.

In embodiments, methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, may comprise detection of a dye. Suchmethods, for example, may comprise reducing the volume of sample used inthe assay from a first volume to a second volume, wherein said secondvolume is less than said first volume, wherein the assay was previouslyperformed using a first volume of sample; and increasing the amount of adye added to the sample, where the dye labels a target substance in saidsample. Such methods may allow detection, quantification, or detectionand quantification of the target substance in a reduced volume ofsample, since signals from many dyes or other labels are enhanced withgreater amounts of dye.

Thus, as disclosed herein, dyes may be utilized in methods for reducingthe volume of sample used in the performance of an assay for thedetection of, or quantification of, a target substance in a sample. Dyessuitable for use in the methods disclosed herein include fluorescentdyes, chemiluminescent dyes, nuclear dyes, membrane dyes, Nile Blue,Coomassie blue, rhodamine dyes, fluorescein dyes, Sybr dyes, DRAQ5 andrelated dyes, fluorescent proteins (e.g., green fluorescent protein andrelated proteins), resazurin (7-Hydroxy-3H-phenoxazin-3-one 10-oxide);10-acetyl-3,7-dihydroxyphenoxazine (Amplex Red) and similar compounds(e.g., Amplex UltraRed (A36006 from Life Technologies, Carlsbad, Calif.92008); resorufin compounds (e.g., 7-ethoxyresorufin); dyes such ase.g., fluorescein, calcein, rhodamine, and ethidium dyes;N-methyl-4-hydrazino-7-nitrobenzofurazan; acridinium(acridine-9-carboxylic acid) esters and compounds which react with thesecompounds to alter an optical property of a solution; phenols and phenolderivatives (e.g., p-iodophenol and p-phenylphenol); luminescent amines,including amine adducts (e.g., as may be derived from copper cyanide),silver stain, and other dyes and stains as disclosed herein and as knownand used in the art.

Further methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, may comprise detection of an enzymaticlabel. Such methods, for example, may comprise reducing the volume ofsample used in the assay from a first volume to a second volume, whereinsaid second volume is less than said first volume, wherein the assay waspreviously performed using a first volume of sample; and increasing theconcentration of substrate added in the presence of the enzyme prior to,or during enzymatic label measurements. Such methods may allowdetection, quantification, or detection and quantification of the targetsubstance in a reduced volume of sample, since signals from manyenzymatic labels are enhanced at higher levels of substrateconcentration.

Thus, as disclosed herein, enzymatic labels and substrates may beutilized in methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample. Enzymes and substrates suitable for use inthe methods disclosed herein include horseradish peroxidase (the enzyme)and peroxide (the substrate). Although horseradish peroxidase isspecifically recited herein, any peroxidase (and substrates of theperoxidase) that participates in a reaction with its substrate(s) toform a colored product may be used in the detection and/orquantification of an analyte in a sample. For example, the coloranthorseradish peroxidase (HRP) participates in a reaction with any one ormore of several molecules effective to change the optical properties ofa solution to which the HRP is added (e.g., by changing the color, theabsorbance of light through a solution to which the HRP is added, and/orother optical properties of the solution). For example, HRP may reactwith an aniline-containing compound such asN-Ethyl-N-(2-hydroxy-3-sulfopropyl)-3,5-dimethoxyaniline (ALPS), or withan aminoantipyrene compound such as 4-aminoantipyrene or with phenoliccompounds. Thus, for example, a peroxidase (e.g., HRP, myeloperoxidase,or other peroxidase), an aniline-containing compound, and anaminoantipyrene may all be termed “colorants.” In further examples, HRPmay react with a benzidine-containing compound (e.g., withdiaminobenzidine (DAB); tetramethylbenzidine (TMB);2,2′-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (DABS);3-dimethylaminobenzoic acid (DMAB); hydroquinone; o-tolidine;o-phenylenediamine; o-chlorophenol; p-hydroxy-benzenesulfonate;p-anisidine; a Trinder reagent (such as 4-aminoantipyrene,methylbenzothiazolinonehydrazone (MBTH), or other compound for producinga Trinder dye); and derivatives and related compounds) to form a coloredproduct. HRP or other peroxidase may also react with other compounds toform a chemiluminescent product; for example, HRP or other peroxidasemay react with luminol to form a chemiluminescent product (othermolecules may be present, and may enhance such reactions; for example,HRP-mediated production of luminescent products from luminol is enhancedin the presence of 4-iodophenol). It will be understood that otherenzymes and reactants may be used to form colored products useful forthe detection of an analyte in a sample.

Alkaline phosphatase reagents are commercially available; for example,Nitroblue Tetrazolium (NBT) is used with the alkaline phosphatasesubstrate 5-Bromo-4-Chloro-3-Indolyl Phosphate (BCIP) to provide acolored product which may be observed and quantitated. Other reagentsinclude Fast Red TR/Naphthol AS-MX and TR phosphate(4-Chloro-2-methylbenzenediazonium/3-Hydroxy-2-naphthoic acid2,4-dimethylanilide phosphate, reagents for the production ofp-nitrophenol, and others known in the art may be used.

Further methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, include methods where the assay compriseslabeled antibody detection of a target substance. Such methods comprise,for example, reducing the volume of sample used in the assay from afirst volume to a second volume, wherein said second volume is less thansaid first volume, wherein the assay was previously performed using afirst volume of sample; and increasing the concentration of labeledantibody, or increasing the number of labels per antibody, or alteringthe label to provide a more detectable signal. Such methods may allowdetection, quantification, or detection and quantification of the targetsubstance in a reduced volume of sample, since signals from more, ormore highly labeled, or more detectably labeled antibodies are enhancedas compared to signals provided by the original methods.

Methods for labeling antibodies are known in the art, including methodsfor providing multiple labels, or different labels, on antibodies.Methods of conjugating labels and other moieties to antibodies and otherproteins are discussed, for example, in Wofsy et al. Selected Methods inCellular Immunology, p. 287, Mishel and Schiigi (eds.) San Francisco: W.J. Freeman Co. (1980)); Arnon et al., “Monoclonal Antibodies ForImmunotargeting Of Drugs In Cancer Therapy”, in Monoclonal AntibodiesAnd Cancer Therapy, Reisfeld et al. (eds.), pp. 243-56 (Alan R. Liss,Inc. 1985); Hellstrom et al., “Antibodies For Drug Delivery”, inControlled Drug Delivery (2nd Ed.), Robinson et al. (eds.), pp. 623-53(Marcel Dekker, Inc. 1987); Thorpe, “Antibody Carriers Of CytotoxicAgents In Cancer Therapy: A Review”, in Monoclonal Antibodies '84:Biological And Clinical Applications, Pinchera et al. (eds.), pp.475-506 (1985); “Analysis, Results, And Future Prospective Of TheTherapeutic Use Of Radiolabeled Antibody In Cancer Therapy”, inMonoclonal Antibodies For Cancer Detection And Therapy, Baldwin et al.(eds.), pp. 303-16 (Academic Press 1985), and Thorpe et al., Immunol.Rev., 62:119-58 (1982).

Further methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, include assays comprising detection of anoptical signal produced by a target substance, or by a reagent whichbinds to or reacts with the target substance. Such methods comprise, forexample, reducing the volume of sample used in the assay from a firstvolume to a second volume, wherein said second volume is less than saidfirst volume, wherein the assay was previously performed using a firstvolume of sample; and increasing the sensitivity of an optical detectorused to detect a signal indicative of the presence or, or amount of,target substance in the sample. Such a method may allow detection,quantification, or detection and quantification of the target substancein a reduced volume of sample, since increased sensitivity to signalsindicative of the presence or, or amount of, target substance in asample will allow detection and quantification from smaller or lessintense signals, such as those signals expected from smaller volumesamples.

In embodiments, an optical detector may be located so as to be able toreceive and to detect light coming from, or light passing through, asample container. In embodiments, an optical detector is located outsidea sample container. In embodiments, an optical detector may be operablyconnected with a fiber-optic conduit effective that light carried by thefiber optic conduit may be directed to the optical detector, and may bedetected by the optical detector. In embodiments, the optical detector,or a fiber-optic conduit, may be located at least partially within asample container, e.g., at least partially within an insert cavity of asample container.

The sensitivity of a detector may be increased by providing additionalsensors or detectors; by replacing a less-sensitive detector or sensorwith a more-sensitive detector or sensor; by providing lenses, mirrors,or other optical enhancements which collect or focus a signal and directit to the sensor or detector; by reducing “noise” in the sensor ordetector (e.g., by cooling the sensor or detector, or by filtering thepower driving the sensor or detector, or by other means); and by othermeans.

A related method for reducing the volume of sample used in theperformance of an assay for the optical detection of, or opticalquantification of, a target substance in a sample, comprises reducingthe volume of sample, and decreasing the separation between the sampleand an optical detector used to detect a signal indicative of thepresence or, or amount of, target substance in the sample. Such a methodmay allow detection, quantification, or detection and quantification ofthe target substance in a reduced volume of sample, since such a reducedseparation allows detection smaller signals indicative of the presenceor, or amount of, target substance in a sample, such as those signalsexpected from smaller volume samples.

Further methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, include methods where the assay comprisesdetection of optical absorbance produced by a target substance, or by atarget substance and a reagent which binds to or reacts with the targetsubstance. Such methods may comprise reducing the volume of sample usedin the assay from a first volume to a second volume, wherein said secondvolume is less than said first volume, wherein the assay was previouslyperformed using a first volume of sample; and increasing the path lengthwithin the sample between a source of illumination and through thesample to an optical detector used to detect an absorbance signalindicative of the presence or, or amount of, target substance in thesample. Increasing the optical path length through the sample provides alarger signal, since more sample is traversed by the light travelingalong the longer path through the sample.

Such a method may allow detection, quantification, or detection andquantification of the target substance in a reduced volume of sample,since such an increased path length through the sample would allowdetection smaller signals indicative of the presence or, or amount of,target substance in a sample, such as those signals expected fromsmaller volume samples. In embodiments, such an increased path lengthmay be provided, even for a reduced volume sample, by, for example,providing a cuvette or other sample container having a long, narrowchamber, in which the sample resides and along the long portion of whichthe illumination is provided. Such a cuvette or sample containercomprises an altered chamber dimension as compared to a cuvette orsample container as used in the assay for larger volume samples. Inembodiments, such an increased path length may be provided, even for areduced volume sample, by, for example, providing a mirror or mirroredsurface at a position at or near a wall of the cuvette or other samplecontainer, so that light from an illumination source follows a longerpath, including a reflected portion, within the sample resides prior todetection of the light for an absorption measurement. Such a longer pathfor use with a reduced volume sample is longer as compared to a path forabsorption measurements for larger volume samples.

Further methods for reducing the volume of sample used in theperformance of an assay for the detection of, or quantification of, atarget substance in a sample, include methods where the assay comprisesdetection of an optical signal produced by a target substance, or by areagent which binds to or reacts with the target substance. Such methodsmay comprise reducing the volume of sample used in the assay from afirst volume to a second volume, wherein said second volume is less thansaid first volume, wherein the assay was previously performed using afirst volume of sample; and altering the wavelength of light, ordetecting multiple wavelengths of light, passing through or absorbed bya smaller volume of sample. Such a method may allow detection,quantification, or detection and quantification of the target substancein a reduced volume of sample, since such an altered light wavelength,or such a plurality of wavelengths, allow detection smaller signalsindicative of the presence or, or amount of, target substance in asample, such as those signals expected from smaller volume samples.

Alteration of wavelengths of light may be accomplished by altering alight source; by passing light from a light source through a filter, orthrough a prism, or other optical element; by providing one or moreadditional light source(s); or any combination of these, among othermethods which may be used to alter light wavelengths used to illuminatea sample.

Further methods for reducing the volume of sample used in theperformance of an assay for the optical detection of, or opticalquantification of, a target substance in a sample, include altering thepolarization of light used to illuminate a sample. Such methods maycomprise reducing the volume of sample used in the assay from a firstvolume to a second volume, wherein said second volume is less than saidfirst volume, wherein the assay was previously performed using a firstvolume of sample; and altering the polarization of light passing throughor absorbed by a smaller volume of sample. Such a method may allowdetection, quantification, or detection and quantification of the targetsubstance in a reduced volume of sample, since such altered lightpolarization allows detection signals indicative of the presence or, oramount of, target substance in a sample, such as those signals expectedfrom smaller volume samples.

Altering the polarization of light may be accomplished, for example, byaltering a light source; by passing light from a light source through afilter, or through a prism, or grating, or slit (or slits), or otheroptical element; by reflecting light from a surface; or any combinationof these, among other methods which may be used to alter thepolarization of light used to illuminate a sample.

Applicants further disclose a method for reducing the volume of sampleused in the performance of an assay for the detection of, orquantification of, a target substance in a sample, where the assaycomprises detection of an electrical signal produced by a targetsubstance, or by a reagent which binds to or reacts with the targetsubstance, the method comprising:

Reducing the volume of sample used in the assay from a first volume to asecond volume, wherein said second volume is less than said firstvolume, wherein the assay was previously performed using a first volumeof sample; and increasing the electronic amplification of an electricaldetector used to detect an electrical signal indicative of the presenceor, or amount of, target substance in the sample. Such a method mayallow detection, quantification, or detection and quantification of thetarget substance in a reduced volume of sample, since such an increasedelectronic amplification of such an electrical detector would allowdetection smaller signals indicative of the presence or, or amount of,target substance in a sample, such as those signals expected fromsmaller volume samples. Electrical detectors include, withoutlimitation, ion-selective electrodes, amperometric detectors, andvoltammetric detectors. Such detectors provide electronic output, andamplification of signals from such detectors may be performed bystandard electronic techniques and devices. Amperometric techniques arediscussed, for example, in “Amperometric Techniques” by Thomas Rousselet al., in the Encyclopedia of Microfluidics and Nanofluidics, pages39-47, Springer Verlag (2008). Voltammetric techniques are discussed,for example, in Kounaves, “Voltammetric Techniques”, Chapter 37 (pages709-725) in: Handbook of Instrumental Techniques for AnalyticalChemistry, edited by Frank Settle, Prentice-Hall (1997). Ion-selectiveelectrodes are discussed, for example, in Primer: Ion selectivemeasurement in online analysis, by YSI, a Xylem brand (2012) (availableat: http://www.ysi.com/media/pdfs/ba76001-Online-ISE-Primer-e01.pdf).

In embodiments, an ion-selective electrode may be, e.g., asodium-selective electrode, a potassium-selective electrode, achloride-selective electrode, or other ion-selective electrode. Anamperometric detector or a voltammetric detector may be used to detectthe presence or concentration of ions or small molecules in a sample;for example, an amperometric or voltammetric detector may be used todetect the presence or concentration of, e.g., oxygen, an amino acidsuch as glutamate or dopamine, a drug such as aspirin or acetaminophen,a natural compound such as caffeine, or other element or molecule in asample. In embodiments, an ion-selective electrode, an amperometricdetector, or a voltammetric detector may be disposed at least partiallywithin a sample container, e.g., within an insert cavity of a samplecontainer. In embodiments, a portion, e.g., a tip, of an ion-selectiveelectrode, an amperometric detector, or a voltammetric detector may bedisposed at least partially within a sample container, e.g., within aninsert cavity of a sample container.

A method for reducing the volume of sample used in the performance of anassay for the detection of, or quantification of, a target substance ina sample, the method comprising:

Reducing the volume of sample used in the assay from a first volume to asecond volume, wherein said second volume is less than said firstvolume, wherein the assay was previously performed using a first volumeof sample; and increasing the temperature of the assay. Such a methodmay allow detection, quantification, or detection and quantification ofthe target substance in the reduced volume of sample, since many labelsand labeling reactions are enhanced at higher temperatures than at lowertemperatures. For example, where photodetection of an enzymatic label(e.g., alkaline phosphatase, horse radish peroxidase, or other enzymaticlabel) in which the rate of production of a detectable product may betemperature sensitive, increased signal may be produced by reaction athigher temperatures. For example, where an assay is performed at roomtemperature (e.g., near 20° C.), increasing the assay temperature toabout 25° C., or about 30° C., or about 32° C., or about 34° C., orabout 35° C., or about 36° C., or about 37° C., or about 38° C., orabout 39° C., or about 40° C., or higher, may increase the signalproduced by an otherwise unchanged reaction.

Reducing the Time Required to Perform an Assay

Reducing the amount of time required to perform an assay (whilemaintaining the accuracy or precision of the assay) allows forprocessing more samples in a unit time than would otherwise be possible.Methods for reducing assay duration are discussed, for example, in U.S.Patent Applications 61/858,589, filed Jul. 25, 2013; U.S. PatentApplication 61/903,346, filed Nov. 12, 2013; and U.S. patent applicationSer. No. 14/341,422, filed Jul. 25, 2014, the contents of all of whichapplications are hereby incorporated by reference in their entireties.

Methods for reducing the amount of time required to perform an assay forthe detection of, or quantification of, a target substance in a sample,include, but are not limited to, the following methods.

A method for reducing the time required for the performance of an assayfor the detection of, or quantification of, a target substance in asample, the method comprising:

Increasing the Temperature of the Assay

A further method for reducing the time required for the performance ofan assay for the detection of, or quantification of, a target substancein a sample, the method comprising:

Reducing the volume of sample used in the assay from a first volume to asecond volume, wherein said second volume is less than said firstvolume, and wherein the assay was previously performed using a firstvolume of sample; and increasing the temperature of the assay.

Such methods may allow detection, quantification, or detection andquantification of the target substance in the sample, since many therate of reactions producing labels and labeling reactions are increasedat higher temperatures than at lower temperatures. For example, wherephotodetection of an enzymatic label (e.g., alkaline phosphatase, horseradish peroxidase, or other enzymatic label) in which the rate ofproduction of a detectable product may be temperature sensitive, adetectable amount of signal may be produced more quickly at highertemperatures than at lower temperatures. For example, where an assay isperformed at room temperature (e.g., near 20° C.), increasing the assaytemperature to about 25° C., or about 30° C., or about 32° C., or about34° C., or about 35° C., or about 36° C., or about 37° C., or about 38°C., or about 39° C., or about 40° C., or higher, may reduce the amountof time required to produce a detectable amount of the signal, ascompared to the original (lower temperature) reaction.

Devices for Reducing the Volume of a Sample (e.g., Inserts)

Sample analysis devices, and sample analysis systems including sampleanalysis devices, typically have one or more sample containers which areconfigured to hold a sample during sample analysis (e.g., duringprocessing, or during analyzing, or both). Applicants disclose hereindevices, systems, and methods for reducing the volume of sample requiredfor, or used in, sample analysis.

Embodiments of these devices for reducing the amount of sample needed orused for sample analysis include inserts configured to fit inside asample container, and to provide a chamber in which a sample—of smallervolume than the volume of sample held by the sample container—may beheld during analysis by a sample analysis device or sample analysissystem. The sample container with an insert within it, and sample withinthe insert, may be used to perform sample analysis of the sample in theinsert. Thus, a sample container with an insert within it, and samplewithin the insert, may be used to perform processing steps, analyzingsteps, or both processing steps and analyzing steps on the sample in theinsert.

Embodiments of devices for reducing the amount of sample needed or usedfor sample analysis include inserts configured to replace a samplecontainer, and to provide a smaller chamber than the one in the samplecontainer. A sample—of smaller volume than the volume of sample held bythe sample container—may be held in an insert that replaces a samplecontainer during analysis by a sample analysis device or sample analysissystem.

A sample container includes a cavity, or internal chamber, which mayhold a sample. A sample container is typically designed so that fluid(e.g., a sample) held within the sample container is retained bygravity; that is, the wall or walls of the cavity are typicallyvertical, or nearly vertical, when the sample container is in use. Asample container has an opening through which a sample may be introducedinto the bore of the sample container; the opening may define a plane,and the “width” the opening may be termed as being in an orientationthat is substantially parallel to the plane of the opening. Thus, inorder to introduce a sample into the cavity of a sample container, thesample passes through the plane of the opening (e.g., along a pathsubstantially perpendicular to the plane of the opening). The “depth” ofthe cavity of a sample container may be termed as being in anorientation substantially perpendicular to the plane of the opening.

A device placed within the cavity, or internal chamber, of a samplecontainer reduces the volume within the sample container that isavailable to hold the sample. Thus, placing an object or device within asample container reduces the effective volume of the sample containercavity and reduces the volume of sample that may be held within thesample container. An object of any shape able to fit within the samplecontainer, while leaving some volume available to hold a sample, may beused to reduce the volume of sample used in the performance of an assay.In embodiments, such an object may be an insert configured to fit withina sample container, where the insert includes a cavity or chamberconfigured to hold a sample. Placement of such an insert is effective toreduce the internal volume available to hold a sample.

Accordingly, Applicants disclose herein designs and descriptions forinserts to be placed within a cavity of a sample container, thereby toreduce the effective volume of the cavity of a sample container, andthus to reduce the volume of sample used or required for the performanceof sample analysis. For example, an insert configured to fit within asample container may fit snugly within the cavity, or chamber, of asample container, leaving little or no space between the outer wall ofthe insert and the inner wall of the sample container's cavity orchamber. For example, such an insert may be configured to fit snuglywithin a sample container and have a cavity or chamber which isconfigured to hold a sample with little risk of loss due to leakage, orspillage. An insert fits within the cavity of a sample container. Thewall or walls of such an insert define its cavity, termed an “insertcavity”; an insert cavity has a smaller volume than the cavity of thesample container. In embodiments, the walls of an insert, and an insertcavity within an insert, may be configured to allow transmission oflight or other signals through the insert. In embodiments, an insertconfigured to allow transmission of light or other signals through theinsert is configured to allow such transmission with little loss oflight intensity, or with little distortion, or with little effect onlight polarization, or combinations thereof.

A sample container (e.g., an original sample container as supplied with,or commonly used with, a sample analysis device) may have a cavity forholding a sample, and the volume of such a cavity may be, for example,about 500 μL, or about 1 mL, or about 2 mL, or about 3 mL, or about 5mL, or about 10 mL, or more. An insert configured to fit within thecavity of an original sample container has an insert cavity; the volumeof such an insert cavity will be less than the volume of the cavity ofan original sample container. Placement of an insert in to the cavity ofan original sample container is effective to reduce the volume of samplethat is required, or that is used, during sample analysis. Suchplacement of an insert into the cavity of an original sample containerprovides a smaller volume cavity for holding sample during sampleanalysis; use of the smaller-volume “insert cavity” of the insert thusenables sample analysis requiring or using less sample than would berequired, or used, with an original sample container.

Thus, the insert cavity (the internal cavity of an insert configured tofit within the cavity of a sample container) may have a volume of lessthan about 500 μL, or less than about 400 μL, or less than about 300 μL,or less than about 250 μL, or less than about 200 μL, or less than about150 μL, or less than about 100 μL, or less than about 50 μL, or lessthan about 25 μL, or less than about 15 μL, or less than about 10 μL, orless than about 5 μL, or less than about 4 μL, or less than about 3 μL,or less than about 2 μL, or less than about 1 μL, or less. Use of suchan insert allows the handling and analysis of smaller volumes of samplethan does the use of an original sample container. It will be understoodthat an original sample container may be replaced by a replacementsample container, or other sample container, where the replacement orother sample container has a cavity with a smaller volume than thevolume of the cavity of the original sample container. In the following,the cavity of a replacement sample container, or other sample container,will also be referred to as an “insert cavity”; such an insert cavityhas a volume that is less than the volume of the original samplecontainer which is replaced by the replacement sample container, orother sample container. For example, a replacement sample container, orother sample container, may have an insert cavity having a volume ofless than about 500 μL, or less than about 400 μL, or less than about300 μL, or less than about 250 μL, or less than about 200 μL, or lessthan about 150 μL, or less than about 100 μL, or less than about 50 μL,or less than about 25 μL, or less than about 15 μL, or less than about10 μL, or less than about 5 μL, or less than about 4 μL, or less thanabout 3 μL, or less than about 2 μL, or less than about 1 μL, or less.

An insert (or replacement sample container, or other sample container)may be made from glass (e.g., borosilicate glass, aluminosilicate glass,quarts, or other glass), or a plastic or acrylic compound (e.g.,polymethyl methacrylate, or other acrylics), or a polymer (such as,e.g., polypropylene, polystyrene, polycarbonate, polyurethane, and otherpolymers), or combinations of these, or other material or combinationsof materials. Preferred materials, such as acrylic compounds, providegood fluid flow, enhancing recovery of fluid from the well of theinsert. In embodiments, such a material is translucent. In embodiments,such a material is transparent. In alternative embodiments, such amaterial may be opaque.

An example of an insert configured to fit within a sample container isshown in FIG. 1. Insert 110 has an insert cavity 120 defined by avertical wall 130 and a floor 140. The opening 150 of the insert cavity120 allows sample to be placed in, or removed from, the insert 110. Theinsert 110 has an outer wall 160 and a base 170, both of which areconfigured to fit within a sample container. The shape and orientationof the floor 140 may be flat, or may be beveled, or may be rounded, ormay be a combination of such shapes, or may be a complex or an irregularshape. The outer wall 160 of an insert 110 is configured to fit withinthe cavity of a sample container; such an outer wall 160 may be vertical(e.g., as shown in the example shown in FIG. 1), or may be at an angle;for example, an outer wall may be angled so that the outer diameter ofan insert is greatest near the opening, and smallest near the floor, ornear the base of the insert. In embodiments, an insert may have asubstantially cylindrical shape (e.g., as indicated in FIG. 1); or mayhave a tapered, or partially conical shape (e.g., where the diameternear the base is less than the diameter near the opening); or may have asquare, or rectangular, or triangular, or other shape.

Reducing or eliminating the volume that is substantially inaccessible toa tube, needle, pipette tip, probe or sensor is an importantconsideration in the design of an insert. For example, a samplecontainer will typically retain some amount of sample within thecontainer after draining; the amount of sample left in the samplecontainer (the dead volume) is typically lost for further use in sampleanalysis. Some sample containers may have dead volumes of about 200 μL,or about 100 μL, or about 50 μL; however, it is desirable to reduce thedead volume of a sample container.

In addition, some sample containers require there to be an amount ofsample at the bottom of the container in order to fill the samplecontainer up to a level accessible for measurements. Such samplecontainers thus require at least a minimum of sample volume within thecontainer before a measurement of the sample may be made. Some samplecontainers may require about 200 μL, or about 100 μL, or about 50 μL, ofsample in order for the sample level within the sample container to behigh enough for measurement. The volume of the sample required to fillthe sample container to the lowest level necessary in order for ameasurement to be made is typically closely similar in magnitude to thedead volume of the sample container.

It is desirable to eliminate or reduce such sample volume that remainsafter draining a container, or that is used or required—but notmeasured—before a measurement may be obtained; thus, it is desirable tohave a small a dead volume. It is desirable to reduce the amount of deadvolume in a container to less than about 200 μL, or less than about 100μL, or less than about 50 μL, or less than about 40 μL, or less thanabout 30 μL, or less than about 20 μL, or less than about 15 μL, or lessthan about 10 μL, or less than about 5 μL, or less than about 4 μL, orless than about 3 μL. In embodiments, it is desirable to have a samplecontainer with a dead volume of less than about 50 μL, or less thanabout 40 μL, or less than about 30 μL, or less than about 20 μL, or lessthan about 15 μL, or less than about 10 μL, or less than about 5 μL, orless than about 4 μL, or less than about 3 μL.

Thus, it is desirable to reduce the volume of sample remaining in asample container (after draining the container) to a small volume ofsample. In embodiments, such a small volume of sample may comprise lessthan about 50 μL, less than about 40 μL, less than about 30 μL, or lessthan about 25 μL, less than about 20 μL, or less than about 15 μL, orless than about 10 μL, or less than about 5 μL, or less than about 4 μL,or less than about 3 μL, or less than about 2 μL, or less than about 1μL, or less. This may be done by altering the size or the shape, orboth, of the bore in which the sample is held. A bore may be altered soas to reduce the dead volume by providing a rounded (e.g., circular, orelliptical) horizontal cross-sectional shape; a bore may have a squareor rectangular horizontal cross-sectional shape; or other horizontalcross-sectional shape.

A bore may have a volume; reducing the volume of the bore may reduce thedead volume of a bore, and may reduce the volume of sample remaining ina sample container (after draining the container) to a small volume ofsample. The dead volume of a bore, and the volume of sample remaining ina sample container after draining, may be reduced by placement of aninsert into the cavity of an original sample container, where the insertcavity has a smaller dead volume than the original sample container. Thedead volume of a bore, and the volume of sample remaining in a samplecontainer after draining, may be reduced by providing a replacementsample container having a smaller dead volume than the original samplecontainer. Methods of analysis using containers having reduced deadvolume, and having reduced volume of sample remaining in a samplecontainer after draining, include methods of sample analysis, wherein aninsert (placed in an original sample container), or replacement samplecontainer, or other container, is used to hold a sample, and the sampleis analyzed, where the insert, replacement sample container, or othercontainer, has a smaller dead volume than does the original samplecontainer, or has a reduced volume of sample remaining in a samplecontainer after draining.

A sample container having a dead volume, or a volume of sample remainingin a sample container after draining, of less than about 200 μL, or lessthan about 100 μL, or less than about 50 μL, or less than about 40 μL,or less than about 30 μL, or less than about 20 μL, or less than about15 μL, or less than about 10 μL, or less than about 5 μL, or less thanabout 4 μL, or less than about 3 μL or less than about 2 μL, or lessthan about 1 μL, or less, may be provided by placing an insert into asample container having a larger dead volume, or in which a largervolume of sample remains after draining, where the insert has an insertcavity having a dead volume, or volume of sample remaining afterdraining, of less than about 200 μL, or less than about 100 μL, or lessthan about 50 μL, or less than about 40 μL, or less than about 30 μL, orless than about 20 μL, or less than about 15 μL, or less than about 10μL, or less than about 5 μL, or less than about 4 μL, or less than about3 μL or less than about 2 μL, or less than about 1 μL, or less.

A sample container having a dead volume, or volume of sample remainingafter draining, of less than about 200 μL, or less than about 100 μL, orless than about 50 μL, or less than about 40 μL, or less than about 30μL, or less than about 20 μL, or less than about 15 μL, or less thanabout 10 μL, or less than about 5 μL, or less than about 4 μL, or lessthan about 3 μL, or less than about 2 μL, or less than about 1 μL, orless, may be provided by replacing an original sample container (e.g., apreviously-supplied sample container) with a replacement samplecontainer, e.g., a sample container having a dead volume, or volume ofsample remaining after draining, of less than about 200 μL, or less thanabout 100 μL, or less than about 50 μL, or less than about 40 μL, orless than about 30 μL, or less than about 20 μL, or less than about 15μL, or less than about 10 μL, or less than about 5 μL, or less thanabout 4 μL, or less than about 3 μL or less than about 2 μL, or lessthan about 1 μL, or less.

Where a probe is to be placed within a bore of an insert or of areplacement sample container, or of any other sample container (e.g.,during performance of an analysis of a sample), reducing the diameter orwidth of the bore to as closely approximate the diameter or width of theprobe is useful to reduce the amount of inaccessible volume in theinsert. Similarly, where a probe is to be placed within a bore of aninsert or of a replacement sample container, or of any other samplecontainer, reducing the depth of the bore to as closely approximate thedepth achieved by the probe within the bore is useful to reduce theamount of inaccessible volume in the insert, replacement samplecontainer, or other sample container.

Thus, the depth of an insert cavity of an insert, or of a replacementsample container, or of any other sample container is an importantcharacteristic. The depth of an insert cavity, along with the width ofan insert cavity, may be designed so as to reduce the total volume ofthe insert cavity, and also may be designed so as to reduce the volumeof sample which may be inaccessible to a probe inserted into the insertcavity. Reducing the total volume of an insert cavity is a design goalfor providing an insert, or replacement sample container, or othersample container suitable for reducing the amount of sample required forsample analysis. A further design goal for providing an insert orreplacement sample container, or any other sample container suitable forreducing the amount of sample required for sample analysis is to reduce,or eliminate, the volume in the insert cavity that may be inaccessibleto a probe placed in a sample in an insert cavity.

Accordingly, the shape of the floor of the insert cavity is a furtherconsideration in the design of an insert or replacement samplecontainer, or any other sample container. Providing a bevel at the baseof the bore of an insert or replacement sample container, or any othersample container, may aid in allowing a probe to reach its maximum depthwithin a bore, while reducing the amount of inaccessible volume withinthe bore. In addition, a bevel may aid in fluid flow (e.g., flow into,or out of the insert cavity, or both). In embodiments, such a bevel mayinclude a conic (e.g., triangular cross-section) bevel; a circular orhemispherical (e.g., a rounded or partly circular cross-section) bevel;an oval or elliptical (e.g., a rounded but not circular cross-section);or other shape. In embodiments, a bevel may include a combination of twoor more such shapes (e.g., may include conic portions and may includecircular portions; or may include flat portions and circular portions;or may include flat portions and conic portions).

An illustration of an exemplary insert having an insert cavity is shownin FIG. 2A. The perspective view of the insert 200 shows an opening 215through which a sample may pass into the insert cavity 210 (shown inFIG. 2B). The insert 200 shown in FIG. 2A has an upper portion with anouter wall 250, a lower portion with an outer wall 255, and a lip 260.The exemplary insert 200 shown in FIG. 2A has a base 220 at its bottom.A lip 260 may be configured to lodge on a surface of a sample containerwhen an insert 200 is placed within the sample container; thus, a lip260 may help with the proper placement of an insert in a samplecontainer, and so insure the proper operation of a sample analysisdevice or system in which an insert 200 is in place in a samplecontainer. In embodiments, an insert 200 may have no lip 260, and theupper portion wall 250 may be flush with the lower portion wall 255. Thewalls 255 and 260 are shown as being vertical, i.e., perpendicular tothe plane suggested by the opening 215. In embodiments, a lower portionwall 255 may be tapered, so that the insert 200 may be wider nearer theopening 215 than it is nearer the base 220. A wall 250 or 255, or both,may have other shapes and orientations as well; for example, an upperportion wall 250 may have a substantially vertical orientation (e.g.,similar to that shown in FIG. 2A) while a lower portion wall 255 may beangled so as to taper from a wider to narrower along the wall in theupper to lower direction. In embodiments, an upper portion wall 250 maybe tapered, while a lower portion wall 255 may have a substantiallyvertical orientation (e.g., similar to that shown in FIG. 2A). Inembodiments, both an upper portion wall 250 and a lower portion wall 255may be angled so as to taper; the upper taper may be the same as thelower taper, or the upper taper may be different than the lower taper.In embodiments, such tapers may become narrower towards the lowerportion; in embodiments, such tapers may become wider towards the upperportion.

It will be understood that the designs and features of an insert cavityas shown in FIG. 2A apply equally to insert cavities of an insert, to areplacement sample container, and to any other sample container. Thus,the disclosure and discussion regarding FIG. 2A, and the disclosure anddiscussion regarding the other figures herein, may be applied toreplacement sample containers, and to any other sample container, andcavities therein, as well as to inserts and their insert cavities.

An illustration of an exemplary bevel in the bottom portion of an insertcavity is shown in FIG. 2B, which provides a cross-section of an insert200 having features as disclosed herein. In the example shown, the floor230 of the cavity 210 is flat, and has a flat bevel wall 235 disposed atan angle to the vertical inner wall 225 of the cavity 210. As shown, thejunctions between the flat portions are rounded. In embodiments, thejunctions between flat portions may not be rounded. As shown, the bottomportion of the insert cavity 210 includes a flat portion (floor 230) androunded portions (wall angle 240 and floor angle 245). Wall angle 240 isthe angle between inner wall 225 and bevel wall 235; floor angle 245 isthe angle between bevel wall 235 and floor 230. In the example shown,floor 230 is perpendicular to inner wall 225, so that wall angle 240 andfloor angle 245 are complementary. Thus, in the example shown in FIG.2B, floor angle 245 is about 30° and wall angle 240 is about 60°. Inembodiments of inserts having features as disclosed herein, floor angle245 may be between about 10° to about 50° and wall angle 240 may bebetween about 80° to about 40°. In further embodiments of inserts havingfeatures as disclosed herein, floor angle 245 may be between about 25°to about 45° and wall angle 240 may be between about 65° to about 45°.In further embodiments, an inner wall 225 is not perpendicular to floor230; in these embodiments, wall angle 240 and floor angle 245 will notbe complementary. In embodiments, wall 225 need not be vertical; forexample, it may be angled so that the width 265 of the cavity 210 isgreater near the opening 215 than it is near to the floor 230. In theexample shown in FIG. 2B, the depth 270 of cavity 210 is about the sameas the width 265. In embodiments, the ratio of depth 270 to width 265may be between about 0.1:1 to about 10:1 (i.e., from a ratio in whichdepth 270 is about one tenth the width 265, to a ratio in which depth270 is about ten times the width 265). In embodiments, the ratio ofdepth 270 to width 265 may be between about 0.2:1 to about 5:1 (i.e.,from a ratio in which depth 270 is about one fifth the width 265, to aratio in which depth 270 is about five times the width 265). Inembodiments, the ratio of depth 270 to width 265 may be between about0.5:1 to about 3:1 (i.e., from a ratio in which depth 270 is about halfthe width 265, to a ratio in which depth 270 is about 3 times the width265). In embodiments, the ratio of depth 270 to width 265 may be about0.3:1; or about 0.5:1; or about 0.8:1; or about 1:1 (e.g., similar tothat shown in FIG. 2B); or about 1.2:1; or about 1.5:1; or about 1.8:1;or about 2:1; or about 3:1; or about 4:1; or about 5:1; or about 6:1; orabout 8:1; or other ratio.

It will be understood that the designs and features of an insert cavityas shown in FIG. 2B apply equally to insert cavities of an insert, to areplacement sample container, and to any other sample container. Thus,the disclosure and discussion regarding FIG. 2B, and the disclosure anddiscussion regarding the other figures herein, may be applied toreplacement sample containers, and to any other sample container, andcavities therein, as well as to inserts and their insert cavities.

In further embodiments, an insert may be configured to completelyreplace an original sample container (e.g., such a replacement insertmay be considered a replacement sample container). In such embodimentsof devices for reducing the amount of sample needed or used for sampleanalysis, an insert may be configured to replace a sample container byhaving the same, or compatible outside dimensions as the samplecontainer, and having an insert cavity as disclosed herein. The insertcavity of an insert configured to replace a sample container may be thesame as an insert configured to fit within a sample container (e.g., theinsert cavity of a replacement sample container may be sized andconfigured in the same was as described and disclosed herein regardingthe insert cavities of sample container inserts). Thus, in embodiments,an insert configured to replace a sample container may have an insertcavity having the same dimensions, including the same ratio of depth towidth, and the same taper, and the same bevel, as disclosed herein withrespect to inserts configured to be placed within a sample container. Aninsert configured to replace a sample container (e.g., a replacementsample container) may be made from the same materials as disclosedherein as being suitable for inserts configured to be placed within asample container.

Accordingly, inserts configured to be placed within a cavity of a samplecontainer, or replacement inserts configured to substitute for a samplecontainer, are effective to provide a smaller volume chamber for holdingsample during sample analysis. Such inserts are effective to reduce thevolume of sample required for the performance of sample analysis.

Methods of sample analysis include analyzing a sample using an insert,or replacement sample container, or any other sample container, tocontain the sample during the sample analysis. Such methods includeprocessing or analyzing a sample, or both, using an insert, orreplacement sample container, or any other sample container, wherein theinsert, or replacement sample container, or other sample container hasan internal cavity with a small volume, so that only a small volume ofsample is required for sample analysis. Such methods include processingor analyzing a sample, or both, using an insert, or replacement samplecontainer, or any other sample container, wherein the insert, orreplacement sample container, or other sample container has an internalcavity with a small dead volume, so that a large fraction of the samplewithin the internal cavity is available for sample analysis, and only asmall amount, or a small fraction, of the sample within the internalcavity is unavailable for sample analysis.

For example, Applicants disclose herein a method of sample analysis witha sample analysis device using a sample container, wherein said sampleis contained within said sample container during at least a portion ofthe performance of said sample analysis, said sample containercomprising an internal cavity for holding said sample, said internalcavity having a volume, said internal cavity volume being less thanabout volume of less than about 500 μL, or less than about 400 μL, orless than about 300 μL, or less than about 250 μL, or less than about200 μL, or less than about 150 μL, or less than about 100 μL, or lessthan about 50 μL, or less than about 25 μL, or less than about 15 μL, orless than about 10 μL, or less than about 5 μL, or less than about 4 μL,or less than about 3 μL, or less than about 2 μL, or less than about 1μL, or less, the method comprising:

-   -   placing a sample within said internal cavity of said sample        container, and    -   performing the sample analysis.

It will be understood that the sample analyzed as recited above maycomprise the entire sample obtained from a subject, or may comprise aportion of the entire sample obtained from a subject. It will beunderstood that the sample analysis may include processing, analyzing,or both.

In embodiments, the internal cavity of the sample container recited inthe above method as disclosed herein comprises the internal cavity of aninsert; the insert may be disposed within the cavity of an originalsample container. In embodiments, the internal cavity of the samplecontainer recited in the above method as disclosed herein comprises theinternal cavity of a replacement sample container. In embodiments, theinternal cavity of the sample container recited in the above method asdisclosed herein comprises the internal cavity of another samplecontainer.

Applicants further disclose a method of sample analysis with a sampleanalysis device using a sample container, wherein said sample iscontained within said sample container during at least a portion of theperformance of said sample analysis, said sample container comprising aninternal cavity for holding said sample, said internal cavity having adead volume, said dead volume being less than about 200 μL, less thanabout 100 μL, or less than about 50 μL, or less than about 30 μL, orless than about 20 μL, or less than about 15 μL, or less than about 10μL, or less than about 5 μL, or less than about 4 μL, or less than about3 μL, or less than about 2 μL, or less than about 1 μL, or less, themethod comprising:

-   -   placing a sample within said internal cavity of said sample        container, and    -   performing the sample analysis.

It will be understood that the sample analyzed as recited above maycomprise the entire sample obtained from a subject, or may comprise aportion of the entire sample obtained from a subject. It will beunderstood that the sample analysis may include processing, analyzing,or both.

In embodiments, the internal cavity of the sample container recited inthe above method as disclosed herein comprises the internal cavity of aninsert; the insert may be disposed within the cavity of an originalsample container. In embodiments, the internal cavity of the samplecontainer recited in the above method as disclosed herein comprises theinternal cavity of a replacement sample container. In embodiments, theinternal cavity of the sample container recited in the above method asdisclosed herein comprises the internal cavity of another samplecontainer.

A method of sample analysis with a sample analysis device having asample container, wherein said sample is contained within said samplecontainer during at least a portion of the performance of said sampleanalysis, said sample container comprising an internal cavity forholding said sample said internal cavity comprising a bevel in thebottom portion of an insert cavity, wherein the cross-sectional shape ofsaid bevel comprises a triangular, circular, hemispherical, oval,elliptical, or other shape, the method comprising:

-   -   placing a sample within said internal cavity of said sample        container, and    -   performing the sample analysis.

It will be understood that the sample analyzed as recited above maycomprise the entire sample obtained from a subject, or may comprise aportion of the entire sample obtained from a subject. It will beunderstood that the sample analysis may include processing, analyzing,or both.

In embodiments, the internal cavity of the sample container recited inthe above method as disclosed herein comprises the internal cavity of aninsert; the insert may be disposed within the cavity of an originalsample container. In embodiments, the internal cavity of the samplecontainer recited in the above method as disclosed herein comprises theinternal cavity of a replacement sample container. In embodiments, theinternal cavity of the sample container recited in the above method asdisclosed herein comprises the internal cavity of another samplecontainer.

A method of sample analysis with a sample analysis device having asample container, wherein said sample is contained within said samplecontainer during at least a portion of the performance of said sampleanalysis, said sample container comprising an internal cavity forholding said sample, said internal cavity comprising an angle effectiveto provide a taper in at least an upper portion, or a lower portion, orboth, of a wall of said internal cavity, wherein the taper comprisestapers selected from tapers in which the upper taper the same as thelower taper; the upper taper is different than the lower taper; taperswhich become narrower towards the lower portion; and tapers which becomewider towards the lower portion; the method comprising:

-   -   placing a sample within said internal cavity of said sample        container, and    -   performing the sample analysis.

It will be understood that the sample analyzed as recited above maycomprise the entire sample obtained from a subject, or may comprise aportion of the entire sample obtained from a subject. It will beunderstood that the sample analysis may include processing, analyzing,or both.

In embodiments, the internal cavity of the sample container recited inthe above method as disclosed herein comprises the internal cavity of aninsert; the insert may be disposed within the cavity of an originalsample container. In embodiments, the internal cavity of the samplecontainer recited in the above method as disclosed herein comprises theinternal cavity of a replacement sample container. In embodiments, theinternal cavity of the sample container recited in the above method asdisclosed herein comprises the internal cavity of another samplecontainer.

A method of sample analysis with a sample analysis device having asample container, wherein said sample is contained within said samplecontainer during at least a portion of the performance of said sampleanalysis, said sample container comprising an internal cavity forholding said sample, said internal cavity comprising a bevel, a wall, afloor, and a wall angle formed by said wall and said bevel, wherein thewall angle comprises an angle of between about 80° to about 40°, orbetween about 65° to about 45°, the method comprising:

-   -   placing a sample within said internal cavity of said sample        container, and    -   performing the sample analysis.

It will be understood that the sample analyzed as recited above maycomprise the entire sample obtained from a subject, or may comprise aportion of the entire sample obtained from a subject. It will beunderstood that the sample analysis may include processing, analyzing,or both.

In embodiments, the internal cavity comprises a floor angle formed bythe floor and the bevel; and in embodiments, the wall angle iscomplementary to the floor angle.

In embodiments, the internal cavity of the sample container recited inthe above method as disclosed herein comprises the internal cavity of aninsert; the insert may be disposed within the cavity of an originalsample container. In embodiments, the internal cavity of the samplecontainer recited in the above method as disclosed herein comprises theinternal cavity of a replacement sample container. In embodiments, theinternal cavity of the sample container recited in the above method asdisclosed herein comprises the internal cavity of an other samplecontainer.

A method of sample analysis with a sample analysis device having asample container, wherein said sample is contained within said samplecontainer during at least a portion of the performance of said sampleanalysis, said sample container comprising an internal cavity forholding said sample, said internal cavity comprising a depth and awidth, wherein the ratio of the depth to the width is between about0.1:1 to about 10:1; between about 0.2:1 to about 5:1; or between about0.5:1 to about 3:1; or may be about 0.3:1; or may be about 0.5:1; or maybe about 0.8:1; or may be about 1:1; or may be about 1.2:1; or may beabout 1.5:1; or may be about 1.8:1; or may be about 2:1; or may be about3:1; or may be about 4:1; or may be about 5:1; or may be about 6:1; ormay be about 8:1; or may be another ratio, the method comprising:

-   -   placing a sample within said internal cavity of said sample        container, and    -   performing the analysis.

It will be understood that the sample analyzed as recited above maycomprise the entire sample obtained from a subject, or may comprise aportion of the entire sample obtained from a subject. It will beunderstood that the sample analysis may include processing, analyzing,or both.

In embodiments, the internal cavity of the sample container recited inthe above method as disclosed herein comprises the internal cavity of aninsert; the insert may be disposed within the cavity of an originalsample container. In embodiments, the internal cavity of the samplecontainer recited in the above method as disclosed herein comprises theinternal cavity of a replacement sample container. In embodiments, theinternal cavity of the sample container recited in the above method asdisclosed herein comprises the internal cavity of another samplecontainer.

Kits for Reducing the Volume of a Sample

A device, or devices, which may be inserted into a sample container maybe provided as part of a kit; thus a kit may include an insert asdisclosed herein, or may include a plurality of such inserts. Inembodiments, a kit may include a replacement sample container asdisclosed herein, or may include a plurality of such replacement samplecontainers. In embodiments, a kit may include another sample container,or may include a plurality of other sample containers. In embodiments, aplurality of the replacement sample containers are coupled together in apredetermined configuration such as but not limited to a ring of suchcontainers, a disc with a plurality of such containers, partial ring ofsuch containers, or other geometric configuration defined by couplingcontainers together. In one non-limiting example, the coupling togetherof containers may be by way of connecting elements, by forming thecontainers formed together with connecting elements, or using othermanufacturing techniques to connect the containers together. Thisgrouping of containers may facilitate the process of installing aplurality of such sample containers. Optionally, the common grouping mayalso be used to facilitate installation of a plurality of inserts.

In embodiments, a kit may include instructions for the use of theinserts, replacement sample containers, and other sample containers,including instructions for placement of the inserts into a samplecontainer, instructions for cleaning an insert, and other instructions.A kit may include materials for maintaining, including materials forcleaning, an insert. A kit may include tools useful for placing aninsert into a sample container, or for removing an insert from a samplecontainer. A kit may include materials useful for securing, or for thesecure placement of an insert into a sample container, or for insuringthat an insert remains in place within a sample container afterplacement. A kit may include reagents for use with the inserts and witha sample container.

For example, instructions for the use of the inserts may include suchinformation as that it may be desirable to insure that an insert isfully in place within a sample container before use; or that it may bedesirable to clean (e.g., rinse with detergent, or solvent, followed bya rinse with water, such as de-ionized water; or to a rinse with waterwithout use of detergents or solvents) prior to placement within asample container; and other instructions. A kit may include instructionsfor the proper handling of an insert (e.g., use of gloves to avoidcontamination during placement) of an insert into a sample container.

A kit may include materials for maintaining, including materials forcleaning, an insert. For example, where the insert may be cleaned with adetergent or solvent, the detergent or solvent may be provided as partof a kit. Water, such as de-ionized water, may be provided as part of akit. A kit may include tools useful for handling an insert; for example,tongs or clamps (which may include, e.g., elongated handles for ease ofplacement of an insert in a location that is otherwise difficult toaccess by hand). A kit may include clamps, or tape, or shims, or othermaterials which may be useful for securing an insert in a samplecontainer. A kit may include reagents (e.g., diluents, reactants, orother reagents) for use with the inserts and with a sample container.

Systems for Reducing the Volume of a Sample

Systems for reducing the volume of sample required for sample analysisinclude an analysis device, a sample container, and an insert forplacement within a sample container. In embodiments, systems forreducing the volume of sample required for sample analysis include ananalysis device, a sample container, and a replacement sample container.In embodiments, systems for reducing the volume of sample required forsample analysis include an analysis device, a sample container, andanother sample container. As discussed above, a device as disclosedherein may be provided for placement within the cavity, or chamber, of asample container, effective to reduce the volume within the samplecontainer. The sample container, with insert, may be placed within ananalysis device, and a sample placed in the sample container (i.e.,within the insert disposed within the sample container) and the sampleanalyzed. In this way, a system is provided effective to analyze asample, where the volume of the sample required or analysis is reducedas compared to the volume required by the analysis device in the absenceof the insert, and in the absence of the use of methods disclosedherein. Such an insert, as disclosed herein, reduces the volume of thesample container and reduces the volume of sample that may be heldwithin the sample container. Thus, systems comprising an insert(including any insert of any shape suitable to fit within a samplecontainer, while leaving some volume available to hold a sample), may beused to reduce the volume of sample used in the performance of sampleanalysis. Thus, systems comprising a replacement sample container may beused to reduce the volume of sample used in, or required for, theperformance of sample analysis. Thus, systems comprising another samplecontainer may be used to reduce the volume of sample used in, orrequired for, the performance of sample analysis. FIG. 3A provides anillustration of a system including an analysis device, a samplecontainer, and an insert configured to fit within the sample container.An analysis system 300 is shown, including an analysis device 310, whichuses a sample container 320 having outer wall 330 to hold a sampleduring analysis. Sample container 320 has a cavity 340 defined by aninner wall of the sample container (shown with dashed lines). Fittedwithin the sample container cavity 340 is an insert 350; the insert 350has an insert cavity 360 (shown with dotted lines).

The sample container 320 (with the insert 350 in place within the cavity340 of the sample container) is in place within the analysis device 310,effective that a sample may be analyzed by the analysis device 310.However, with the insert 350 in place within the cavity 340 of thesample container 320, the volume of sample that is analyzed is less thanthe volume of sample that would have been required if the insert 350 hadnot been placed within the cavity 340 of the sample container 320.

An insert is thus configured to reduce the sample volume required forsample analysis by an analysis device or an analysis system. Inembodiments, an insert has features as disclosed herein, and isconfigured to enhance fluid flow in the insert cavity. In embodiments,an insert has features as disclosed herein, and is configured both toreduce the sample volume required for sample analysis by an analysisdevice or analysis system, and to enhance fluid flow in the insertcavity.

FIG. 3B provides an illustration of an analysis system 300 including ananalysis device 310, but without a sample container. In place of asample container, a sample is held by an insert 350 configured toreplace the sample container; analysis by sample analysis device 310proceeds with the sample held in insert cavity 360 (shown with dottedlines) within the insert 350. The outer wall 370 of the insert 350 thatreplaces a sample container has dimensions and shape that is compatiblewith the analysis device 310; thus, outer wall 370 of the insert 350 is,as far as is necessary to operably fit in analysis device 310, the sameas outer wall 330 of the sample container as shown in FIG. 3A.

Insert 350, positioned in place of a sample container within theanalysis device 310, is effective to hold a small volume of sample foranalysis by analysis device 310. The volume of sample that is analyzedin this way is less than the volume of sample that would have beenrequired if the insert 350 had not been used in place of the samplecontainer (e.g., sample container 320).

Applicants have performed experiments using commercial analysis devicesby modifying some aspects of the hardware and some aspects of thesoftware in order to customize assays used to analyze blood samples.General approaches used in these modifications include, for example,reducing the final volume read by the detector; optimization of thedilution levels for each assay; not using the ion selective electrodedetectors; optimizing the chloride content of reagents and optimizingthe protocols which use chloride-containing reagents; modifying thedesign of the sample container to reduce sample volume and to reduceoverage (e.g., reduce the risk of spills or wasted sample); including apredilution step in order to predilute the plasma in the samplecontainers; selecting which assays should be done in solutionscontaining a first anticoagulant such as but not limited to EDTA andwhich in solutions of a second and different anticoagulant such as butnot limited to heparin, in order to meet the assay requirements while atthe same time also minimizing sample volume desired for each assay. Suchmodifications were aimed at optimizing assay protocols so as to minimizeoverages in dilution vessels and in pipetting operations.

This document contains material subject to copyright protection. Thecopyright owner (Applicant herein) has no objection to facsimilereproduction of the patent documents and disclosures, as they appear inthe US Patent and Trademark Office patent file or records, but otherwisereserves all copyright rights whatsoever. The following notice shallapply: Copyright 2013-2014 Theranos, Inc.

We claim:
 1. A method of analyzing a small-volume fluid sample with asystem for analyzing a small-volume fluid sample, wherein said systemcomprises: an automated sample analysis device, said device beingconfigured for use with a plurality of sample containers, each of saidsample containers having a cavity, said cavity having a first volume,wherein each of said sample containers is configured to hold a fluidsample within said cavity; a plurality of inserts coupled together in apredetermined configuration, each of said inserts for placement withinthe cavity of one of the sample containers, each of said inserts havinga first outer portion have a first diameter greater than a diameter ofthe cavity and a second outer portion have a second outer diameter, andan insert cavity configured to hold a fluid sample of no more than about150 μL, wherein the second outer diameter is sized so that the secondouter portion is in slidable contact with the cavity of the samplecontainer said insert cavity having a second volume, said second volumebeing smaller than said first volume; wherein the insert cavity has awall, said wall comprising an angle effective to provide a taper in atleast an upper portion, or a lower portion, or both, of said wall ofsaid insert cavity, wherein the taper comprises tapers selected fromtapers in which the upper taper the same as the lower taper; the uppertaper is different than the lower taper; tapers which become narrowertowards the lower portion; and tapers which become wider towards thelower portion; placing said insert within said sample container, whereinsaid insert comprises an insert cavity for holding said sample having avolume of less than an original volume, said insert cavity comprising abevel, a wall, a floor, and a wall angle formed by said wall and saidbevel, wherein the wall angle comprises an angle of between about 80° toabout 40°, placing said small-volume fluid sample within said insertcavity, and analyzing the small-volume sample with said automated sampleanalysis device.
 2. The method of claim 1, wherein said insert cavityhas a dead volume, said dead volume having a volume of less than about50 μL.
 3. The method of claim 1, wherein the wall angle of said insertcavity comprises an angle of between about 65° to about 45°.
 4. Themethod of claim 2, wherein said insert cavity comprises a depth and awidth, wherein the ratio of the depth to the width is between about0.1:1 to about 10:1.
 5. The method of claim 2, wherein said insertcavity comprises a depth and a width, wherein the ratio of the depth tothe width is about 5:1.
 6. The method of claim 3, wherein said insertcavity comprises a bevel in a bottom portion of said insert cavity,wherein a cross-sectional shape of said bevel comprises a triangular,circular, hemispherical, oval, or elliptical shape.
 7. The method ofclaim 3, wherein said insert cavity comprises a depth and a width,wherein the ratio of the depth to the width is between about 0.1:1 toabout 10:1.
 8. A method of analyzing a small-volume fluid sample with asystem for analyzing a small-volume fluid sample, wherein said systemcomprises: an automated sample analysis device, said device beingconfigured for use with a plurality of sample containers, each of saidsample containers having a cavity, said cavity having a first volume,wherein each of said sample containers is configured to hold a fluidsample within said cavity; a plurality of inserts coupled together in apredetermined configuration, each of said inserts for placement withinthe cavity of one of the sample containers, each of said inserts havinga first outer portion have a first diameter greater than a diameter ofthe cavity and a second outer portion have a second outer diameter, andan insert cavity configured to hold a fluid sample of no more than about≜μL, wherein the second outer diameter is sized so that the second outerportion is in slidable contact with the cavity of the sample containersaid insert cavity having a second volume, said second volume beingsmaller than said first volume; wherein the insert cavity has a wall,said wall comprising an angle effective to provide a taper in at leastan upper portion, or a lower portion, or both, of said wall of saidinsert cavity, wherein the taper comprises tapers selected from tapersin which the upper taper the same as the lower taper; the upper taper isdifferent than the lower taper; tapers which become narrower towards thelower portion; and tapers which become wider towards the lower portion;placing said insert within said sample container, wherein said insertcomprises an insert cavity for holding said sample having a volume ofless than an original volume, said insert cavity comprising a bevel, awall, a floor, and a wall angle formed by said wall and said bevel,wherein the wall angle comprises an angle of between about 80° to about40°, lacing said small-volume fluid sample within said insert cavity,and analyzing the small-volume sample with said automated sampleanalysis device; wherein said insert cavity has a dead volume, said deadvolume having a volume of less than about 30 μL.
 9. A method ofanalyzing a small-volume fluid sample with a system for analyzing asmall-volume fluid sample, wherein said system comprises: an automatedsample analysis device, said device being configured for use with aplurality of sample containers, each of said sample containers having acavity, said cavity having a first volume, wherein each of said samplecontainers is configured to hold a fluid sample within said cavity; aplurality of inserts coupled together in a predetermined configuration,each of said inserts for placement within the cavity of one of thesample containers, each of said inserts having a first outer portionhave a first diameter greater than a diameter of the cavity and a secondouter portion have a second outer diameter, and an insert cavityconfigured to hold a fluid sample of no more than about 150 μL, whereinthe second outer diameter is sized so that the second outer portion isin slidable contact with the cavity of the sample container said insertcavity having a second volume, said second volume being smaller thansaid first volume; wherein the insert cavity has a wall, said wallcomprising an angle effective to provide a taper in at least an upperportion, or a lower portion, or both, of said wall of said insertcavity, wherein the taper comprises tapers selected from tapers in whichthe upper taper the same as the lower taper; the upper taper isdifferent than the lower taper; tapers which became narrower towards thelower portion; and tapers which become wider towards the lower portion;placing said insert within said sample container, wherein said insertcomprises an insert cavity for holding said sample having a volume ofless than an original volume, said insert cavity comprising a bevel, awall, a floor, and a wall angle formed by said wall and said bevel,wherein the wall angle comprises an angle of between about 80° to about40°, placing said small-volume fluid sample within said insert cavity,and analyzing the small-volume sample with said automated sampleanalysis device; wherein said insert cavity has a dead volume, said deadvolume having a volume of less than about 20 μL.